A Prototype Anal Continence Plug

There is increasing dissatisfaction with the longer term results of anal incontinence surgery [1–7]. In some cases less than 50% of patients retain complete continence 2 or 3 years after surgery. Minor imperfections of continence persist after a range of colorectal procedures. Conservative management with a low residue diet and antidiarrhoeal medication such as codeine phosphate and Imodium® has limited value in patients with gross incontinence [4]. We have therefore designed a prototype anal continence plug. Using a similar principle and similar materials to those employed for the Conseal colostomy plug, the plug, shaped like a champagne cork, is made of polyvinyl alcohol sponge and the stem coated in a lubricated cover which dissolves on placement in the anal canal (Fig. 1). The appliance then gently expands to size to fill the anal canal. It is disposable so that when the subject appreciates an evacuatory desire the plug can simply be expelled by raised intrabdominal pressure and the defaecatory reflex.