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

Healy, C.; Brannigan, A. E.; Connolly, Elizabeth; Eng, Molly; O’Sullivan, M. J.; McNamara, Deborah A.; Cusack, Cinny; Deasy, Joseph

doi:10.1007/s00384-006-0102-0

Cited by 24 publications

(17 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…It was also neglected in some two-group randomized trials where two ES stimulations were compared and both ES were below the threshold for effectiveness [ 13 ]. Stimulation with alternating current at medium frequency (MF > 1,000 Hz; amplitude-modulated medium frequency: AM-MF), also termed pre-modulated interferential ES in the literature, does not have the disadvantage of LFS because its biological effect is based on a different principle than the all-or-nothing effect of LFS [ 16 ]. Previous systematic reviews [Supplementary Table S 1 ; 17 – 19 ] did not distinguish between LFS and MF therapies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Vonthein

Heimerl

Schwandner

et al. 2013

Int J Colorectal Dis

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

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

View full text Add to dashboard Cite

show abstract

“…A study by Healy et al in 2006 randomized 48 patients to endoanal electrical stimulation with a home unit versus endoanal electrical stimulation plus augmented biofeedback under supervision of a physical therapist. 41 Both groups improved in terms of continence scores, manometric pressure readings posttreatment, and quality of life.…”

Section: Summary Of Selected Trials Involving Electrical Stimulation mentioning

confidence: 88%

Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence

Scott

2014

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

Fecal incontinence (FI) is a prevalent problem that can drastically affect quality of life. Pelvic floor rehabilitation is an important first-line treatment for patients with FI, and many published case reports and a small number of randomized controlled trials (RCTs) provide limited evidence for its efficacy. Pelvic floor rehabilitation approaches to the treatment of FI include pelvic floor muscle training, biofeedback, and volumetric training with rectal balloon catheters. Various forms of external electrical stimulation have also been described and may be of added benefit. Behavioral bowel retraining is an important part of a good rehabilitative approach as well. Pelvic floor rehabilitation treatment for FI is thought to be effective and safe, with reported success rates in a majority of studies at 50 to 80%. Many more high-quality RCTs are needed to define optimal treatment protocols.

show abstract

“…Low frequencies (10-20 Hz) are used to treat urge incontinence and high frequencies (35-50 Hz) are used to treat stress incontinence 6. Little is known, however, about the effectiveness of EST using anal plugs in anorectal functional disorders, especially in patients with fecal incontinence 7,8,12…”

Section: Discussionmentioning

confidence: 99%

“…As EST may rehabilitate the pelvic floor muscle, it has been tested in defecation disorders. EST using an anal plug has been shown successful in up to 60% of patients with fecal incontinence 7,8…”

Section: Introductionmentioning

confidence: 99%

Electrical Stimulation Therapy in Chronic Functional Constipation: Five Years' Experience in Patients Refractory to Biofeedback Therapy and With Rectal Hyposensitivity

Jung

Yang

Yoon

et al. 2013

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsBiofeedback therapy (BFT) can be unsuccessful in constipated patients, even those with pelvic floor dysfunction. Electrical stimulation therapy (EST) has been introduced as a novel therapeutic modality in patients with chronic constipation, especially those who have rectal hyposensitivity. We evaluated the efficacy of EST based on five years' clinical experience.MethodsFrom January 2002 to February 2007, 159 patients underwent EST. After exclusion of 12 drop-outs, 147 (M:F = 61:86, 49 ± 17 years) finished all treatment sessions. Among them, 88 (M:F = 29:59, 49 ± 17 years) were refractory to BFT without rectal hyposensitivity (RH), and 59 (M:F = 32:27, 54 ± 17 years) were those with RH.ResultsThe overall response to EST was 59.2% (87/147) by per-protocol analysis. In the EST-responsive group, overall satisfaction improved significantly (from 7.3 ± 3.0 to 4.3 ± 2.5, P < 0.05). Subgroup analysis showed that the response rate was 64.8% (57/88) in patients refractory to BFT without RH, and 50.8% (30/59) in those with RH.ConclusionsEST may have additional therapeutic efficacy in patients who are refractory to BFT. EST may also be effective in patients with RH, including restoration of rectal sensation. Therefore, EST could be considered as an alternative choice in patients refractory to BFT and with or without RH.

show abstract

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

Abstract: 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.

Cited by 24 publications

References 17 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

Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence

Electrical Stimulation Therapy in Chronic Functional Constipation: Five Years' Experience in Patients Refractory to Biofeedback Therapy and With Rectal Hyposensitivity

Contact Info

Product

Resources

About