Does electrical stimulation of the pelvic floor alter the proctographic parameters in faecal incontinence?

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Abstract

Objective

To evaluate the effects of electrical stimulation of the pelvic floor on proctographic parameters in patients with faecal incontinence.

Design

Patients with faecal incontinence, resistant to medical or surgical management, were randomly selected for anorectal studies.

Patients

The study included 24 patients suffering from idiopathic faecal incontinence with anal sphincter weakness and detectable pudendal neuropathy randomly selected for treatment with a pudendoanal reflex electrical stimulator.

Interventions

Manometric studies, electrophysiological tests and X-ray video-proctography were performed before and after chronic intermittent application of a pudendo-anal reflex electrical stimulator over 8 weeks.

Main outcome measure

Improvement in the parameters relating to continence control.

Results

The intra-anal pressures showed an increase in the cough (P < 0.0001), voluntary contraction (P < 0.03) and maximum resting (P < 0.004) pressures. The functional length of the anal canal was also enhanced (P < 0.004). The anorectal angles remained unchanged; however, there was a significant increase in the pelvic floor ascent (P < 0.02), with no change in descent. The poststimulator group had fewer patent anal canals (P < 0.04).

Conclusions

Chronic neuro-stimulation of the pelvic floor can be used to restore continence.

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