Application of nanofat for treatment of traumatic faecal incontinence after sphincteroplasty – A pilot study

Abstract

Aim: The aim of this study was to investigate whether the application of nanofat contain-ing stem cells improves continence in women who had previously undergone anal sphinc-teroplasty with unsatisfactory long-term outcomes.Method: This prospective pilot study included nine women with various degrees of anal incontinence who had previously undergone anal sphincteroplasty due to obstetric trauma. In all patients, the Wexner Incontinence Score (WS) and Faecal Incontinence Quality of Life Score (FIQLS), as well as anal manometry and endoanal ultrasound meas-urements, were performed before the procedure and during follow-up. In all patients, liposuction was performed and 50 ml of raw lipoaspirate was obtained and processed using a NanoFat Kit device. Approximately 20 ml of the mechanically emulsified and fil-trated fat was obtained and the anal sphincter complex was infiltrated with it. Patient fol-low-up was conducted in person or via telephone 6 and 12 months after the procedure.Results: The squeeze pressure was significantly increased 6 months after the proce-dure (p= 0.01). The external anal sphincter measured at the 12 o'clock position was sig-nificantly thicker (p= 0.04). A significant decrease in the WS was observed both 6 and 12 months after the procedure compared with baseline values (p< 0.05 for both).Conclusion: This study is the first to show that the application of nanofat as an inject-able product improves continence in patients with unsatisfactory results after sphinc-teroplasty, suggesting it to be a promising and effective therapeutic tool. The procedure is safe and can be easily performed as an ambulatory procedure.