We report the case of a 61-year-old woman with urinary and anal incontinence due to neurologic disease. An AMS 800 artificial sphincter was implanted first round the bladder neck with recovery of satisfactory urinary continence. Four months later, another AMS 800 artificial sphincter was implanted round the anal sphincter. Two revisionai procedures had to be performed: replacement of the pump for mechanical failure, and replacement of the lowpressure balloon by a high-pressure one. Finally the patient has been almost completely continent with only occasional leakage of feces or liquid stools (follow-up 24 months after activation). Defecography shows total rectal evacuation and anorectal manometry records an anal closing pressure of 70 cm H(2)O. Dual implantation of artificial sphincters is possible for incontinence of neurological origin, provided bladder and rectal compliance are normal.

Keywords:
Anal incontinence, Urinary incontinence, Incontinence surgery, Artificial sphincter, Neuromuscular disorder
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1997
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