Eighteen years of experience in laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency.

INTRODUCTION AND OBJECTIVES: Artificial urinary sphincter (AUS) is a treatment option for women with stress urinary incontinence (SUI) after failure of previous surgery or as a primary procedure in severe intrinsic sphincter deficiency (ISD). The aim of the study was to assess the long-term efficacy and risk factors for surgical revision and definitive explantation of AUS laparoscopic implantation in female patients. METHODS: A retrospective review of all women submitted to AUS implantation between April 2005 and March 2023 was conducted. The AUS was implanted via transperitoneal laparoscopic approach, by two experienced surgeons. The primary endpoint was postoperative continence. Continence was defined as no leakage and no pad usage or leakage and/or pad usage with no impact on social life and failure as leakage and/or pad usage impacting social life. As secondary outcomes, clinical predictive factors for AUS revision and definitive explantation were evaluated. RESULTS: In the last 18 years, females with a mean age of 68±12 years-old were submitted to laparoscopic implantation of AUS. Early overall complication rate was 16%, but only one case was Clavien-Dindo ≥3. After a median follow-up of 67 months, 22.2% of the patients needed a device revision, the majority due to mechanical device dysfunction. AUS definitive explantation was performed in 16%, mainly due to urethral/vaginal erosion (9.9%) and infection (6.2%). Patients with age ≥70 years and follow-up ≥10 years significantly predisposed for device revision. At the time of the last follow-up, 72% of the patients were keeping the urinary continency. CONCLUSIONS: Laparoscopic AUS implantation in females is an effective treatment for SUI due to ISD. Meanwhile, adequate patient selection, multidisciplinary evaluation and careful expectation management are essential to achieving good results, concerning their significant complication rate.

Glaucoma drainage devices in children: an updated review.

Implantation of glaucoma drainage devices is a valuable therapeutic option, particularly in children with glaucoma refractory to primary surgical treatment. Glaucoma drainage devices are typically used when conjunctival scarring hampers filtration surgery or prior angle procedures are not effective in controlling intraocular pressure. Despite known complications, the use of glaucoma drainage devices in children has increased in recent years, even as the primary surgical option. In this review, we evaluate the results of recent studies involving the implantation of glaucoma drainage devices in children, discussing new advances, and comparing the success rates and complications of different devices.

Biomimetic design and clinical application of Ti-6Al-4V lattice hemipelvis prosthesis for pelvic reconstruction.

OBJECTIVE: This study aims to biomimetic design a new 3D-printed lattice hemipelvis prosthesis and evaluate its clinical efficiency for pelvic reconstruction following tumor resection, focusing on feasibility, osseointegration, and patient outcomes. METHODS: From May 2020 to October 2021, twelve patients with pelvic tumors underwent tumor resection and subsequently received 3D-printed lattice hemipelvis prostheses for pelvic reconstruction. The prosthesis was strategically incorporated with lattice structures and solid to optimize mechanical performance and osseointegration. The pore size and porosity were analyzed. Patient outcomes were assessed through a combination of clinical and radiological evaluations. RESULTS: Multiple pore sizes were observed in irregular porous structures, with a wide distribution range (approximately 300-900 µm). The average follow-up of 34.7 months, ranging 26 from to 43 months. One patient with Ewing sarcoma died of pulmonary metastasis 33 months after surgery while others were alive at the last follow-up. Postoperative radiographs showed that the prosthesis's position was consistent with the preoperative planning. T-SMART images showed that the host bone was in close and tight contact with the prosthesis with no gaps at the interface. The average MSTS score was 21 at the last follow-up, ranging from 18 to 24. There was no complication requiring revision surgery or removal of the 3D-printed hemipelvis prosthesis, such as infection, screw breakage, and prosthesis loosening. CONCLUSION: The newly designed 3D-printed lattice hemipelvis prosthesis created multiple pore sizes with a wide distribution range and resulted in good osteointegration and favorable limb function.

Cataract surgery and artificial iris implantation in patient with oculocutaneous albinism: a case report.

We present a case report detailing the successful phacoemulsification surgery with artificial iris implantation for two individuals with oculocutaneous albinism. These women suffered from cataracts, resulting in reduced visual acuity and heightened photophobia due to iris pigmentary epithelium deficiency. The patients underwent phacoemulsification along with prosthetic artificial iris implantation into the posterior chamber. This intervention resulted in improved visual acuity, reduced photophobia and glare, and an overall enhanced quality of life. Our report highlights two cases of successful phacoemulsification and artificial iris implantation in patients with oculocutaneous albinism and cataracts, leading to improved visual acuity, reduced photophobia, and enhanced quality of life. Notably, there are no prior records in South American literature of cataract surgery combined with artificial iris implantation for oculocutaneous albinism patients up to the time of this publication.

Subcutaneous air entrapment after subcutaneous implantable cardioverter defibrillator implantation evaluated by computed tomography.

BACKGROUND: Inappropriate shock (IAS) caused by subcutaneous air entrapment (AE) in an early period after subcutaneous implantable cardioverter defibrillator (S-ICD) implantation has been reported, however, no detailed data on air volume are available. We evaluated the subcutaneous air volume after implantation and its absorption rate one week after implantation. METHODS: Patients who underwent S-ICD implantation in our hospital received chest CT scans immediately after implantation and followed up 1 week later. The total subcutaneous air volume, air around the generator, the distal electrode, and the proximal electrode within 3 cm were calculated using a three-dimensional workstation. Fat areas at the level of the lower edge of the generator were also analyzed. RESULT: Fifteen patients received CT immediately after implantation. The mean age was 45.6 ± 17.9 (66.7% of men), and the mean body mass index was 24.3 ± 3.3. The three-incision technique was applied in seven patients and two-incision technique was in the latter eight patients. The mean total subcutaneous air volume was 18.54 ± 7.50 mL. Air volume around the generator, the distal electrode, and the proximal electrode were 11.05 ± 5.12, 0.72 ± 0.72, and 0.88 ± 0.87 mL, respectively. Twelve patients received a follow-up CT 1 week later. The mean total subcutaneous air was 0.25 ± 0.45 mL, showing a 98.7% absorption rate. CONCLUSION: Although subcutaneous air was observed in all patients after S-ICD implantation, most of the air was absorbed within 1 week, suggesting a low occurrence of AE-related IAS after a week postoperation.

Modular intercalary prosthetic reconstruction for malignant and metastatic tumours of the proximal femur.

To illustrate the surgical technique and explore clinical outcomes of the reconstruction for the malignant and metastatic bone tumour of proximal femur with metallic modular intercalary prosthesis. Sixteen patients who underwent modular intercalary prosthetic reconstruction after tumour resection were included from April 2012 and October 2020. Prosthesis and screws parameters, resected bone length and residual bone length, clinical outcomes and survivorship were analyzed. All patients were followed up for an average of 19 months (range 1-74). In our series, 12 patients died of the progression of the primary disease at the final follow-up. The cumulative survivorship since the treatment of proximal femoral metastasis was 78.6% (11 patients) at 6 months and 38.5% (5 patients) at 1 year. The mean MSTS score was 22.25 ± 4.55 among all patients. There were no cases of loosening or breakage of the prostheses, plates or screws, despite the various measurements of prostheses and residual bones. Modular intercalary prosthetic reconstruction was an effective method for malignant tumour of the proximal femur, including the advantages of providing early pain relief, quickly restoring postoperative function, required a short operation time, and preserving the adjacent joints.

[Clinical results of the eyeWatch system: 1-year outcomes]. / Klinische Ergebnisse des eyeWatch-Systems: 1-Jahres-Outcome.

BACKGROUND: The eyeWatch System (EWS) (Rheon Medical, Lausanne, Switzerland) was developed as a glaucoma drainage device (GDD) to precisely control intraocular pressure (IOP) and thus prevent the development of postoperative hypotension and its complications. OBJECTIVE: To report 1­year outcomes from a single-center cohort undergoing EWS surgery. MATERIAL AND METHODS: Retrospective review of patients undergoing EWS surgery at the University Eye Hospital Bonn, Germany from May 2021 to September 2022. RESULTS: A total of 5 eyes of the first 5 consecutive patients treated with the EWS were included in this study. The mean preoperative IOP was 34.6 mm Hg (23-45 mm Hg) which was reduced to 12.2 mm Hg (9-18 mm Hg) with a mean reduction of 60%. Local pressure-lowering therapy was reduced from 2.8 agents preoperatively (1-4) to 0.6 agents after 1 year. All patients achieved the target IOP of below 21 mm Hg including 4 patients without any medication. The complication rate was low. One patient had to undergo two surgical revisions as the IOP was elevated to over 30 mm Hg after surgery and tube exposure became apparent during the course of the follow-up so that a second donor patch was sutured on. The same patient had an elevated IOP >30 mm Hg after a cMRI examination, so that a reduction of IOP by adjusting the EWS using the eyeWatch pen (EWP) was performed. IOP adjustments with the eyeWatch pen (EWP) were performed in 4 of 5 patients in the first year after surgery; the mean IOP before adjustment was 21.33 mm Hg (15-37 mm Hg) which was reduced to a mean of 8.58 mm Hg (4-16 mm Hg). CONCLUSION: The EWS effectively lowers IOP and the amount of necessary pressure-lowering therapy. With the EWP postoperative adjustments of IOP are possible without further invasive measures.

Factors predicting the visual outcome of intracorneal ring segment for keratoconus.

OBJECTIVES: To identify predictive factors and to construct predictive models using epidemiological and clinical preoperative factors for the visual acuity change after intracorneal ring segment (ICRS) implantation in patients with keratoconus. METHODS: The medical records of 287 keratoconic eyes of 230 patients implanted with ICRS at Chula Refractive Surgery Center of a tertiary university hospital (Bangkok, Thailand) between January 2012 and March 2022 were retrospectively reviewed for epidemiological and clinical preoperative variables, including those derived from Scheimpflug tomography. After randomly excluding one eye for each bilateral case, the remaining 230 eyes were randomized into two groups: a training group (184 eyes) and a validation group (46 eyes). In the training group, the correlation between the interesting variables and postoperative uncorrected and corrected distance visual acuity change (ΔUDVA and ΔCDVA; logMAR scale) at 6 months was explored, and then the multiple linear regression analysis was used to develop the predictive models. The obtained models were tested using the validation group. RESULTS: There were 5 and 14 preoperative variables that statistically correlated with ΔUDVA and ΔCDVA respectively. Only the preoperative corrected distance visual acuity (CDVAp) strongly correlated with ΔCDVA (Beta = -0.746). Using multiple regression, the preoperative uncorrected distance visual acuity (UDVAp) and front mean keratometry were selected in the proposed model for ΔUDVA (adjusted R2 = 38.8%), while the CDVAp and index of surface variance (ISV) were selected in the model [Formula: see text] (adjusted R2 = 48.9%). The ΔUDVA and ΔCDVA models were correct in 47.83% and 63.4% of the validation group within 0.20 logMAR, respectively. CONCLUSIONS: Potential predictive factors and models for ICRS-induced changes in visual acuity are proposed as adjunctive tools for clinicians. Such tools could be used for case selection and during counselling before ICRS implantation to maximize surgical outcomes.

Technique of corneal allogenic ring segment preparation using femtosecond laser: preclinical study on human corneal grafts.

PURPOSE: To describe a new technique for preparing corneal allogenic ring segments (CAIRSs) using femtosecond laser technology. SETTING: Hospital Foundation Adolphe de Rothschild-Noémie de Rothschild institute, Paris, France. DESIGN: Preclinical study conducted on human corneal grafts. METHODS: The corneal grafts were mounted on an artificial chamber pressurizer (ACP) with preset constant pressure, and the FSL was used to create a circular annulus with specific dimensions. The resulting CAIRSs were analyzed for their thickness and width after air drying. RESULTS: A total of 25 CAIRSs were prepared using the FSL. The mean width and thickness of the CAIRSs were 803 ± 77 µm and 83 ± 16 µm, respectively. Statistical analysis revealed no significant differences in width among the various quadrants of each CAIRS or between different CAIRSs. Significantly thicker CAIRSs were obtained with a higher ACP pressure. CONCLUSIONS: The technique of CAIRS preparation using FSL technology and controlled artificial anterior chamber pressure demonstrated reproducibility and precision. This approach holds the potential for customizing and personalizing CAIRSs based on individual corneal characteristics.

Results of intrastromal corneal ring implantation in advanced keratoconus With the aim of postpoing or avoiding corneal transplantation.

PURPOSE: To evaluate the safety and efficacy of the surgery of intracorneal ring segment implantation with 320° of arc (320-ICRS) in patients with advanced keratoconus stage IV and maximum keratometry (Kmax) above 60 D. METHODS: A prospective, interventional case series study evaluating 25 eyes of 19 patients with keratoconus stage IV and Kmax > 60D in which 320-ICRS were implanted using VisuMax® femtosecond. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometric values (mean - mean-K, flat - K1, and steep - K2), maximum keratometry (Kmax), tomographic astigmatism, refractive astigmatism and asphericity (Q) were assessed preoperatively and at 3, 6 and 12 months after the procedure. RESULTS: The UDVA improved from 1.03 ± 0.28 LogMAR (20/200) to 0.54 ± 0.21 LogMAR (20/60), (p < 0.001), the CDVA (with glasses) improved from 0.63 ± 0.29 LogMAR (20/80) to 0.31 ± 0.16 LogMAR (20/40),(p = 0.004), K1 reduced from 54.41 ± 4.46 D to 49.36 ± 4.11 D (p < 0.001), K2 reduced from 61.15 ± 4.37 D to 53.715 ± 4.05 D, (p < 0.001), mean-K reduced from 57.55 ± 4,17 D to 51.44 ± 3,94 D (p < 0.001), Kmax reduced from 69.80 ± 8.20 D to 63.43 ± 6.31 D (p < 0.001) and asphericity (Q) changed from -1.57 ± 0.35 to -0.77 ± 0.56 (p < 0.001). A total of 89.9% patients reached BCVA wearing scleral contact lens  0.2 LogMAR(20/25). CONCLUSION: 320-ICRS to treat advanced keratoconus appears to be an efficacious and safe procedure, being a surgical alternative to delay or even prevent corneal transplantation.

Robot-assisted Periprostatic Artificial Urinary Sphincter Implantation in Men with Neurogenic Stress Urinary Incontinence: Description of the Surgical Technique and Comparison of Long-term Functional Outcomes with the Open Approach.

BACKGROUND: Periprostatic artificial urinary sphincter implantation (pAUSi) is a rare yet relevant indication for male neurogenic stress urinary incontinence (SUI). OBJECTIVE: To describe the surgical technique of robot-assisted pAUSi (RApAUSi) and compare the long-term functional results with the open pAUSi (OpAUSi). DESIGN, SETTING, AND PARTICIPANTS: Data of 65 consecutive men with neurogenic SUI undergoing pAUSi between 2000 and 2022 in a tertiary centre were collected retrospectively. SURGICAL PROCEDURE: Thirty-three patients underwent OpAUSi and 32 underwent RApAUSi. OpAUSi cases were performed by a single surgeon, experienced in functional urology and prosthetic surgery. RApAUSi cases were performed by the same surgeon together with a second surgeon, experienced in robotic surgery. MEASUREMENTS: Outcome measures were achievement of complete urinary continence, intra- and postoperative complications, and surgical revision-free survival (SRFS). RESULTS AND LIMITATIONS: RApAUSi showed superior results to OpAUSi in terms of median (interquartile range) operative time (RApAUSi: 170 [150-210] min vs OpAUSi: 245 [228-300] min; p < 0.001), estimated blood loss (RApAUSi: 20 [0-50] ml vs OpAUSi: 500 [350-700] ml; p < 0.001), and median length of hospital stay (LOS; RApAUSi: 5 [4-6] d vs OpAUSi: 11 [10-14] d; p < 0.001). Clavien-Dindo grade ≥3a complications occurred more frequently after OpAUSi (RApAUSi: 1/32 [3%] vs OpAUSi: 10/33 [30%]; p = 0.014). Achievement of complete urinary continence (zero pads) was comparable between the groups (RApAUSi: 24/32 [75%] vs OpAUSi: 24/33 [73%]; p = 0.500). The median follow-up periods were 118 (50-183) and 56 (25-84) mo for OpAUSi and RApAUSi, respectively (p < 0.001). A tendency towards longer SRFS was observed in the RApAUSi group (p = 0.076). The main study limitation was its retrospective nature. CONCLUSIONS: RApAUSi is an efficient alternative to OpAUSi, resulting in shorter operative times, less blood loss, fewer severe complications, and a shorter LOS with similar functional results and need for revision surgery. PATIENT SUMMARY: Compared with open periprostatic artificial urinary sphincter implantation (pAUSi), robot-assisted pAUSi leads to faster recovery and similar functional results, with fewer postoperative complications.

Efficacy and Safety of an Adjustable Glaucoma Drainage Device (eyeWatch System) for Refractory Glaucoma: A 2-Year Prospective Study.

PRCIS: In this study, we report a 2-year follow-up after implantation of an adjustable glaucoma drainage device combined with a novel orbital filtering plate. The IOP was efficiently controlled postoperatively with limited complications and an excellent safety profile. PURPOSE: To report the clinical results at 2 years after implantation of an eyeWatch (eW) system, which comprises an adjustable glaucoma drainage device (eW implant) combined with a novel orbital filtering plate (eyePlate), in refractory glaucoma. PATIENTS AND METHODS: Monocentric, prospective, noncomparative clinical trial. Patients suffering from refractory glaucoma after several failed surgeries were operated using the eW system. The primary outcome was the success rate, defined as an IOP ≤18 mm Hg and reduction of more than 20% from baseline, IOP ≥6 mm Hg. Secondary outcomes were mean IOP, visual acuity, the number of antiglaucoma medications, and the number and type of complications. RESULTS: Forty-two eyes from 42 patients were included. The mean follow-up time was 22.0±4.0 months. The mean baseline IOP decreased from 23.2±7.2 mm Hg before surgery to 11.9±4.4 mm Hg at 12 months ( P <0.001) and 11.5±3.0 at 24 months. The mean number of glaucoma medications decreased from 2.9±0.9 before surgery to 0.7±0.9 at 12 months ( P <0.001) and 1.0±0.9 at 24 months. The qualified success rate was 93% at 12 months and 90% at 24 months whereas the complete success rate was 46% and 40% at 12 and 24 months, respectively. Complications occurred in 7 patients. CONCLUSIONS: Implantation of the eW system effectively lowered IOP and reduced glaucoma medications for a 2-year period in patients who had previously failed glaucoma surgery. Persistent hypotony was not observed and the number of complications was low.

Five-Year Outcomes of Graft-Free Tube Shunts and Risk Factors for Tube Exposures in Glaucoma.

PRCIS: Use of a scleral tunnel technique instead of a patch graft can be considered in most cases of tube shunt implantation. Grafts may still be considered in younger (<65 y old) East Asians. PURPOSE: (1) To assess the risk factors for tube exposure with a graft-free implantation technique and (2) to examine 5-year outcomes of graft-free tube shunt insertion. METHODS: This was a retrospective case series of 204 consecutive eyes undergoing a glaucoma tube shunt implantation with a scleral tunnel technique in lieu of a graft. Preoperative and postoperative best-corrected visual acuity, intraocular pressure, and number of glaucoma medications were compared. Failure was defined as the following: (1) intraocular pressure >21 mm Hg or ≤5 mm Hg on 2 consecutive visits after 3 mo; (2) required additional glaucoma surgery; (3) loss of light perception. Univariable and multivariable regression analyses were conducted to identify risk factors of tube exposures. RESULTS: Intraocular pressure and the number of glaucoma medications were significantly decreased at all postoperative time points ( P <0.001). Success rates were 91% at year 1, 75% at year 3, and 67% at year 5. The most common early (<3 mo) complication was tube malpositioning. The most common late (>3 mo to 5 y) complications were corneal complications and uncontrolled intraocular pressure. By year 5, 6.9% of tubes were exposed. Multivariable regression showed that age less than 65 years old (odds ratio: 3.66, P =0.04) and East Asian ethnicity (odds ratio: 3.36, P =0.04) were associated with significantly increased risk of tube exposure. CONCLUSIONS: Graft-free glaucoma tube implantation has comparable long-term outcomes and complication rates to shunts with a graft. Younger (<65 y old) East Asians are at greater risk of tube exposure without a graft.

The move-C cervical artificial disc can restore intact range of motion and 3-D kinematics.

BACKGROUND CONTEXT: In contrast to cervical discectomy and fusion, total disc replacement (TDR) aims at preserving the motion at the treated vertebral level. Spinal motion is commonly evaluated with the range of motion (ROM). However, more qualitative information about cervical kinematics before and after TDR is still lacking. PURPOSE: The aim of this in vitro study was to investigate the influence of cervical TDR on ROM, instantaneous centers of rotation (ICR) and three-dimensional helical axes. STUDY DESIGN: An in vitro study with human spine specimens under pure moment loading was conducted to evaluate the kinematics of the intact cervical spine and compare it to cervical TDR. METHODS: Six fresh frozen human cervical specimens (C4-5, median age 28 years, range 19-47 years, two female and four male) were biomechanically characterized in the intact state and after implantation of a cervical disc prosthesis (MOVE-C, NGMedical, Germany). To mimic in vivo conditions regarding temperature and humidity, water steam was used to create a warm and humid test environment with 37°C. Each specimen was quasistatically loaded with pure moments up to ±2.5 Nm in flexion/extension (FE), lateral bending (LB) and axial rotation (AR) in a universal spine tester for 3.5 cycles at 1 °/s. For each third cycle of motion the ROM was evaluated and an established method was used to determine the helical axis and COR and to project them into three planar X-rays. Statistical analysis was conducted using a Friedman-test and post hoc correction with Dunn-Bonferroni-tests (p<.05). RESULTS: After TDR, total ROM was increased in FE from 19.1° to 20.1°, decreased in LB from 14.6° to 12.6° and decreased in AR from 17.7° to 15.5°. No statistical differences between the primary ROM in the intact condition and ROM after TDR were detected. Coupled rotation between LB and AR were also maintained. The position and orientation of the helical axes after cervical TDR was in good agreement with the results of the intact specimens in all three motion directions. The ICR in FE and AR before and after TDR closely matched, while in LB the ICR after TDR were more caudal. The intact in vitro kinematics we found also resembled in vivo results of healthy individuals. CONCLUSION: The results of this in vitro study highlight the potential of artificial cervical disc implants to replicate the quantity as well as the quality of motion of the intact cervical spine. CLINICAL SIGNIFICANCE: Physiological motion preservation was a driving factor in the development of cervical TDR. Our results demonstrate the potential of cervical TDR to replicate in vivo kinematics in all three motion directions.

A robot-assisted laparoscopic revision of an artificial urinary sphincter in a patient with spinal cord injury.

This step-by-step article demonstrates our approach to robot-assisted laparoscopic revision of a bladder neck sited artificial urinary sphincter (AUS) for a spinal cord injured patient. The bladder neck location of an AUS in the spinal cord injured demographic is ideal to minimise urethral complications and urinary tract infections, whilst the transabdominal approach reduces the risk of wound breakdown that can occur via the typical perineal incision for AUS insertion. The accompanying video will guide viewers as to our minimally invasive technique for cuff revision in the event of secondary surgery for recurrent urinary incontinence.

Custom Iris Prosthesis for Subtotal Traumatic Aniridia From Combat Ocular Trauma.

Traumatic aniridia from combat ocular trauma can cause visual disability. A 41-year-old male Army Veteran was referred for evaluation of light sensitivity and glare secondary to subtotal traumatic aniridia of his left eye from an improvised explosive device blast. A custom-made artificial iris prosthesis was implanted in the ciliary sulcus and secured using Gore-Tex sutures. After surgery, the patient reported improvement of his light sensitivity and quality of life. The custom iris prosthesis is a surgical option for visual disability resulting from traumatic aniridia from combat ocular trauma.

Endosonographic monitoring of Sphinkeeper® prostheses movements: does physical activity have an impact?

The Sphinkeeper® procedure for treating faecal incontinence (FI) may be associated with potential implant migration (IM) and dislocation (ID), with considerable variations regarding their occurrence and effects on consecutive functional outcome. This study assessed IM and ID following the Sphinkeeper® procedure and its correlation with physical activity. This was a prospective observational clinical study of ten patients undergoing Sphinkeeper® operation due to FI between August 2020 and November 2020 at the Medical University of Vienna. Patients were followed-up after 1, 2, 3 and 6 months and 1 year postoperatively. Each follow-up visit included endosonographic monitoring of protheses location and manometric examinations. Additionally, functional outcome and physical activity were assessed using validated standardized questionnaires. The median number of prostheses implanted was 10 (IQR 9-10). The St. Mark's incontinence (SMS) score improved significantly until the last follow-up (p = 0.049), without observing a significant effect on the physical SF-12 score. The median rate of implants leading to IM and ID was 3 (range 1-4) and 2 (range 1-2) after 3 months of follow-up. A strong association of deltaSMS with number of dislocated prostheses at one month after Sphinkeeper® implantation was observed (r = 0.654, p = 0.078). Physical activity, assessed by the international physical activity questionnaire, did not have an impact on the correct prosthesis placement (1 month: p = 0.527; 2 months: p = 0.886; 3 months: p = 0.180; 6 months: p = 0.111). IM and ID of Sphinkeeper® prostheses occurred frequently early after surgery and affected functional outcome negatively. Physical activity did not have an influence on the implants displacement.