Artificial Muscle Devices: Innovations and Prospects for Fecal Incontinence Treatment

Abstract

Fecal incontinence describes the involuntary loss of bowel content, which is responsible for stigmatization and social exclusion. It affects about 45% of retirement home residents and overall more than 12% of the adult population. Severe fecal incontinence can be treated by the implantation of an artificial sphincter. Currently available implants, however, are not part of everyday surgery due to long-term re-operation rates of 95% and definitive explantation rates of 40%. Such figures suggest that the implants fail to reproduce the capabilities of the natural sphincter. This article reviews the artificial sphincters on the market and under development, presents their physical principles of operation and critically analyzes their performance. We highlight the geometrical and mechanical parameters crucial for the design of an artificial fecal sphincter and propose more advanced mechanisms of action for a biomimetic device with sensory feedback. Dielectric electro-active polymer actuators are especially attractive because of their versatility, response time, reaction forces, and energy consumption. The availability of such technology will enable fast pressure adaption comparable to the natural feedback mechanism, so that tissue atrophy and erosion can be avoided while maintaining continence during daily activities.

A novel power supply system for puborectalis‐like artificial anal sphincter

“…Besides this situation, many of the patients with FI are ashamed of telling the truth. This causes the underestimation of the prevalence of FI in the investigation 5,6 .…”

Interaction phenomena between a cuff of an artificial urinary sphincter and a urethral phantom

“…In general, AUS consists of an inflatable silicone cuff, a pressure‐regulating balloon (PRB) and a deflating pump . The AMS 800 (Boston Scientific, Boston, MA, USA), which is worldwide considered as the gold‐standard AUS, is based on an occlusive cuff that is approximately 2.0 cm wide when deflated and ranges from 3.5 to 11 cm in length .…”

“…7 In general, AUS consists of an inflatable silicone cuff, a pressure-regulating balloon (PRB) and a deflating pump. 3,8 The AMS 800 (Boston Scientific, Boston, MA, USA), which is worldwide considered as the gold-standard AUS, is based on an occlusive cuff that is approximately 2.0 cm wide when deflated and ranges from 3.5 to 11 cm in length. 2 This cuff is provided as an open deflated band, which is placed by the surgeon around bulbar urethra, shaping it according to the anatomical conformation of urethral duct.…”

Fecal incontinence and nursing approach

“…Sıklık oranları arasındaki farklılık, inkontinansın farklı tanımlanması ve verilerin işlenmesindeki farklı metotların bulunması, bireylerin geriatrik olması ve yarısından fazlasının şikayetlerini dile getirmekten çekinmelerinden kaynaklanmaktadır (9). İngiltere'de yayınlanan klinik uygulama rehberinde fekal inkontinansın üriner inkontinansa göre daha utanç verici bir duygu uyandırdığı ifade edilmiştir (10,11). Fekal inkontinansı olan bireyler kötü koktuklarını düşündüklerinden topluma açık alanlara çıkmaktan utanabilir ve bu durum da sosyal izolasyona neden olabilir.…”