Long-Term Outcomes of PTQ Anal Sphincter Implants for the Management of Faecal Incontinence: A Single Centre Experience.

BACKGROUND

Faecal incontinence can be functionally debilitating, with significant impact on patients' quality of life. Injectable perianal bulking agents such as PTQ implants are shown to improve faecal incontinence in the short- to mid-term; however, long-term outcomes remain poorly understood.

OBJECTIVE

To assess long-term outcomes of PTQ implants for management of faecal incontinence.

METHODS

A retrospective cohort study of 101 patients receiving PTQ implants at St Vincent's Public and Private Hospitals, Fitzroy, between 2007 and 2023. Mean follow up time was 8 years (range 2-17). Primary outcomes were patient satisfaction, duration of improvement and post-treatment quality of life, assessed using Wexner and Faecal Incontinence Quality of Life scores. Secondary outcomes included repeat treatment and complications.

RESULTS

Following treatment with PTQ implants, 56% (n = 55/101) of patients were satisfied with improvement in symptoms. Fifty seven percent (n = 56/101) of patients reported a duration of improvement of at least 1 year and 39% (n = 39/101) for two or more years. Post-treatment quality of life outcomes were poorer in female compared to male patients, whilst no statistically significant difference was otherwise noted between other patient groups. Further intervention to manage symptoms was required in 50% (n = 50/101), of which the majority (n = 31/101) were treated with a second PTQ treatment. Complications were observed in 3% (n = 3/101) of patients.

CONCLUSION

Over half of patients treated with PTQ implants reported satisfaction with its effect on faecal incontinence, with low complication rates. PTQ implants are a minimally invasive treatment option for faecal incontinence that may provide longer-term benefit in appropriately selected patient cohorts.