Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 8/2006

01-12-2006 | Original Article

The effects of low-frequency endo-anal electrical stimulation on faecal incontinence: a prospective study

Authors: Ciaran F. Healy, Ann E. Brannigan, Elizabeth M. Connolly, Molly Eng, Martin J. O’Sullivan, Deborah A. McNamara, Cinny Cusack, Joseph M. Deasy

Published in: International Journal of Colorectal Disease | Issue 8/2006

Login to get access

Abstract

Background and aims

Faecal incontinence is a distressing problem that is often not amenable to surgical correction. Chronic low-frequency electrical stimulation of damaged axons is thought to reduce synaptic resistance, increase the size of motor units by axonal sprouting and increase the rate of conduction of the pudendal nerve. The aim of this study was to prospectively evaluate the effect of chronic low-frequency endo-anal electrical stimulation on faecal incontinence using a home-based unit and hospital-supervised therapy.

Materials and methods

Forty-eight patients with faecal incontinence completed a prospective randomised trial. Patients were allocated randomly to one of two groups; group 1 was exposed to endo-anal pudendal nerve stimulation daily at home with a portable home unit, group 2 attended the physiotherapy department for endo-anal electrical stimulation under supervision.

Results

Continence scores improved significantly after treatment in both groups (p<0.001). Both groups showed improved manometric scores, although only group 1 showed significant improvement in both resting and squeeze pressures (mean total resting pressure 184–224 mmHg, p<0.001; mean total squeeze pressure 253–337 mmHg, p<0.001). This was also reflected by an improvement in quality of life in both groups.

Conclusions

Low-frequency endo-anal electrical stimulation significantly improves continence scores and quality of life in patients with faecal incontinence not amenable to surgical correction. It leads to improved manometric values when carried out on a daily basis with a portable home unit.
Literature
1.
Nelson R, Norton N, Cautley E, Furner S (1995) Community based prevalence of anal incontinence. JAMA 274:559–561PubMedCrossRef
2.
Halverson AL, Hull TL (2002) Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 45(3):345–348PubMedCrossRef
3.
4.
Enck P (1993) Biofeedback training in disordered defecation: a critical review. Dig Dis Sci 38:1953–1960PubMedCrossRef
5.
Laurberg S, Swash M, Snooks SJ et al (1988) Neurologic cause of idiopathic incontinence. Arch Neurol 45:1250–1253PubMed
6.
Gilliland R, Altomare DF, Moreira H Jr et al (1998) Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 41:1516–1522PubMedCrossRef
7.
Swash M (2002) Electrophysiological investigation of the posterior pelvic floor. The pelvic floor: function and disorders. Saunders, London, p 224
8.
Larpent JL, Cuer JC, Da Poigny M (1987) Clinical and manometric results of electrical stimulation in patients with anal incontinence. Coloproctology 9:183–184
9.
Parks AG, Swash M, Urick H (1977) Sphincter denervation in anorectal incontinence and rectal prolapse. Gut 18:656–665PubMed
10.
Kiff ES, Swash M (1984) Slowed conduction in the pudendal nerve in idiopathic neurogenic faecal incontinence. Br J Surg 71:614–616PubMed
11.
Snooks SJ, Swash M, Henry MM et al (1985) Risk factors in childbirth causing damage to the pelvic floor innervation. Br J Surg 72:S15–S17 (Suppl)PubMed
12.
Scheuer M, Kuijpers HC, Bleijenberg G (1994) Effect of electrostimulation on sphincter function in neurogenic faecal continence. Dis Colon Rectum 37:590–594PubMedCrossRef
13.
Rowedder K (1984) Electrostimulation therapy for anal incontinence. Coloproctology 6:178–179
14.
Willis S, Holtz F, Fackeldy V, Schumpelick V (2004) Effect of biofeedback and electrostimulation on sphincter function in fecal incontinence. Zentralbl Chir 129(3)211–215PubMedCrossRef
15.
Hays RD, Sherbourne CD, Mazel RM (1993) The RAND 35-item health survey 1.0. Health Econ 2:217–227PubMed
16.
Jorge JMN, Wexner SD (1992) Etiology and management of faecal incontinence. Dis Colon Rectum 36:77–97CrossRef
17.
Fynes MM, Marshall K, Cassidy M, Behan M, Walsh D, O’Connell PR, O’Herlihy C (1999) A prospective, randomised trial comparing the effect of augmented biofeedback with sensory biofeedback alone on faecal incontinence after obstetric trauma. Dis Colon Rectum 42(6):753–758 JunPubMedCrossRef
18.
Scheuer M, Kuijpers HC, Bleijenberg G (1994) Effect of electrostimulation on sphincter function in neurogenic fecal incontinence. Dis Colon Rectum 37:590–594PubMedCrossRef
19.
Scott OM, Vrbova G, Hude SA et al (1985) Effects of low frequency electrical stimulation on normal human tibialis anterior muscle. J Neurol Neurosurg Psychiatry 48:774–781PubMedCrossRef
20.
Bump RC, Glenn Hurt W, Fantl JL, Wymann JF (1991) Assessment of Kegel pelvic muscle exercise after brief verbal instruction. Am J Obstet Gynecol 165:322–329PubMed
21.
Hill J, Hosker G, Kiff ES (2002) Pudendal nerve terminal motor latency measurements: what they do and do not tell us. Br J Surg 89(10):1268–1269PubMedCrossRef
Metadata
Title
The effects of low-frequency endo-anal electrical stimulation on faecal incontinence: a prospective study
Authors
Ciaran F. Healy
Ann E. Brannigan
Elizabeth M. Connolly
Molly Eng
Martin J. O’Sullivan
Deborah A. McNamara
Cinny Cusack
Joseph M. Deasy
Publication date
01-12-2006
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 8/2006
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-006-0102-0

Other articles of this Issue 8/2006

International Journal of Colorectal Disease 8/2006 Go to the issue

Case Report

Polyposis and early cancer in a patient with low penetrant mutations in MSH6 and APC: hereditary colorectal cancer as a polygenic trait

Letter to the Editor

Unusual complication of rectopexy with polypropylene mesh

Original Article

Manometric study in ulcerative colitis patients with modified ileal pouch–anal anastomosis

Original Article

Overlapping anal sphincter repair and anterior levatorplasty: effect of patient’s age and duration of follow-up

Original Article

Clinical spectrum and surgical approach of adult intussusceptions: a multicentric study

Invited Commentary

Manometric study in ulcerative colitis patients with modified ileal pouch-anal anastomosis by G. Kobakov et al.