Stellenwert von Biofeedback-Training mit kombinierter analer Elektrostimulation bei idiopathischer Stuhlinkontinenz

Willis, S.; Hölzl, Florian; Fackeldey, V.; Schumpèlick, V.

doi:10.1055/s-2004-822743

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…S 1 ), including several systematic reviews (Supplementary Table S 1 ) [ 4 , 17 , 19 , 23 – 36 ]. Twenty-three studies were retrospective chart reviews or prospective case series [ 37 – 59 ], and four current trials [ 60 – 63 ] were found in trial registries, but not in the literature. Seven RCTs [ 15 , 64 – 69 ] met at least one exclusion criterion (Supplementary Table S 2 ), and 13 RCTs remained [ 11 , 14 , 16 , 18 , 70 – 78 ] (Supplementary Tables S 3 to S 5 ).…”

Section: Resultsmentioning

confidence: 99%

Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review

Vonthein

Heimerl

Schwandner

et al. 2013

Int J Colorectal Dis

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PurposeThis systematic review determines the best known form of biofeedback (BF) and/or electrical stimulation (ES) for the treatment of fecal incontinence in adults and rates the quality of evidence using the Grades of Recommendation, Assessment, Development, and Evaluation. Attention is given to type, strength, and application mode of the current for ES and to safety.MethodsMethods followed the Cochrane Handbook. Randomized controlled trials were included. Studies were searched in The Cochrane Library, MEDLINE, and EMBASE (registration number (PROSPERO): CRD42011001334).ResultsBF and/or ES were studied in 13 randomized parallel-group trials. In 12 trials, at least one therapy group received BF alone and/or in combination with ES, while ES alone was evaluated in seven trials. Three (four) trials were rated as of high (moderate) quality. Average current strength was reported in three of seven studies investigating ES; only two studies reached the therapeutic window. No trial showed superiority of control, or of BF alone or of ES alone when compared with BF + ES. Superiority of BF + ES over any monotherapy was demonstrated in several trials. Amplitude-modulated medium-frequency (AM-MF) stimulation, also termed pre-modulated interferential stimulation, combined with BF was superior to both low-frequency ES and BF alone, and 50 % of the patients were continent after 6 months of treatment. Effects increased with treatment duration. Safety reporting was bad, and there are safety issues with some forms of low-frequency ES.ConclusionsThere is sufficient evidence for the efficacy of BF plus ES combined in treating fecal incontinence. AM-MF plus BF seems to be the most effective and safe treatment.Key Messages• The higher the quality of the randomized trial the more likely was a significant difference between treatment groups.• Two times more patients became continent when biofeedback was used instead of a control, such as pelvic floor exercises.• Two times more patients became continent when biofeedback plus electrical stimulation was used instead of biofeedback only.• Low-frequency electrical stimulation can have adverse device effects, and this is in contrast to amplitude-modulated medium-frequency electrical stimulation.• There is high quality evidence that amplitude-modulated medium-frequency electrical stimulation plus electromyography biofeedback is the best second-line treatment for fecal incontinence.Electronic supplementary materialThe online version of this article (doi:10.1007/s00384-013-1739-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review

Vonthein

Heimerl

Schwandner

et al. 2013

Int J Colorectal Dis

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“…It is a successful key element within our treatment algorithm, even in patients with sphincter damage and neuropathic anal incontinence. [4]. Als weitere Option steht inzwischen die sakrale Nervenstimulation zur Verfügung [5].…”

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3T-AI: Ein neuer, mit höherer Evidenz versehener Behandlungsalgorithmus bei analer Inkontinenz

et al. 2011

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“…B. [1], gesammelt in [2]). Zwar wird in Studien der Druck gemessen, den der Schließmuskel aufbauen kann, es werden Komplikationen von Operationen gezählt und manchmal werden die Patienten gefragt, ob sie kontinent sind [3].…”

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Therapiestudien mit Medizinprodukten: Mangelnde Qualität illustriert anhand analer Inkontinenz

et al. 2011

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Stellenwert von Biofeedback-Training mit kombinierter analer Elektrostimulation bei idiopathischer Stuhlinkontinenz

Cited by 6 publications

References 6 publications

Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review

Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review

3T-AI: Ein neuer, mit höherer Evidenz versehener Behandlungsalgorithmus bei analer Inkontinenz

Therapiestudien mit Medizinprodukten: Mangelnde Qualität illustriert anhand analer Inkontinenz

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