Electrical stimulation for faecal incontinence in adults
- PMID: 17636665
- PMCID: PMC8406929
- DOI: 10.1002/14651858.CD001310.pub2
Electrical stimulation for faecal incontinence in adults
Abstract
Background: Faecal incontinence is a particularly embarrassing and distressing condition with significant medical, social and economic implications. Electrical stimulation has been used with apparent success in the treatment of faecal incontinence. However, standards of treatment are still lacking and the magnitude of alleged benefits has yet to be established.
Objectives: To determine the effects of electrical stimulation for the treatment of faecal incontinence in adults.
Search strategy: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 13 March 2007) and reference lists of potentially eligible articles.
Selection criteria: All randomised or quasi-randomised trials evaluating electrical stimulation in adults with faecal incontinence.
Data collection and analysis: Two reviewers assessed the methodological quality of potentially eligible trials and independently extracted data from the included trials. A wide range of outcome measures were considered.
Main results: Four eligible trials with 260 participants were identified. Findings from one trial suggest that electrical stimulation with anal biofeedback and exercises provides more short-term benefits than vaginal biofeedback and exercises for women with obstetric-related faecal incontinence. Another study found contradictory results, with no added benefit from electrical stimulation over biofeedback and exercises alone. Although all trials report that patient's symptoms are generally improved, it is not clear that this is the effect of electrical stimulation. No further conclusions could be drawn from the data available.
Authors' conclusions: At present, there are insufficient data to allow reliable conclusions to be drawn on the effects of electrical stimulation in the management of faecal incontinence. There is a suggestion that electrical stimulation may have a therapeutic effect, but this is not certain. Larger, more generalisable trials are needed.
Conflict of interest statement
None
Update of
-
Electrical stimulation for faecal incontinence in adults.Cochrane Database Syst Rev. 2000;(2):CD001310. doi: 10.1002/14651858.CD001310. Cochrane Database Syst Rev. 2000. Update in: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001310. doi: 10.1002/14651858.CD001310.pub2. PMID: 10796769 Updated.
Similar articles
-
Electrical stimulation for faecal incontinence in adults.Cochrane Database Syst Rev. 2000;(2):CD001310. doi: 10.1002/14651858.CD001310. Cochrane Database Syst Rev. 2000. Update in: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001310. doi: 10.1002/14651858.CD001310.pub2. PMID: 10796769 Updated.
-
Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults.Cochrane Database Syst Rev. 2012 Jul 11;2012(7):CD002111. doi: 10.1002/14651858.CD002111.pub3. Cochrane Database Syst Rev. 2012. PMID: 22786479 Free PMC article.
-
Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults.Cochrane Database Syst Rev. 2006 Jul 19;(3):CD002111. doi: 10.1002/14651858.CD002111.pub2. Cochrane Database Syst Rev. 2006. Update in: Cochrane Database Syst Rev. 2012 Jul 11;(7):CD002111. doi: 10.1002/14651858.CD002111.pub3. PMID: 16855987 Updated.
-
Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults.Cochrane Database Syst Rev. 2000;(2):CD002111. doi: 10.1002/14651858.CD002111. Cochrane Database Syst Rev. 2000. Update in: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD002111. doi: 10.1002/14651858.CD002111.pub2. PMID: 10796859 Updated.
-
Perianal injectable bulking agents as treatment for faecal incontinence in adults.Cochrane Database Syst Rev. 2010 May 12;(5):CD007959. doi: 10.1002/14651858.CD007959.pub2. Cochrane Database Syst Rev. 2010. Update in: Cochrane Database Syst Rev. 2013 Feb 28;(2):CD007959. doi: 10.1002/14651858.CD007959.pub3. PMID: 20464759 Updated.
Cited by
-
Diagnosis, Therapy and Follow-up of Cervical Cancer. Guideline of the DGGG, DKG and DKH (S3-Level, AWMF Registry No. 032/033OL, May 2021) - Part 2 with Recommendations on Psycho-oncology, Rehabilitation, Follow-up, Recurrence, Palliative Therapy and Healthcare Facilities.Geburtshilfe Frauenheilkd. 2022 Feb 11;82(2):181-205. doi: 10.1055/a-1671-2446. eCollection 2022 Feb. Geburtshilfe Frauenheilkd. 2022. PMID: 35197803 Free PMC article.
-
Dutch evidence statement for pelvic physical therapy in patients with anal incontinence.Int Urogynecol J. 2015 Apr;26(4):487-96. doi: 10.1007/s00192-014-2555-y. Epub 2014 Nov 11. Int Urogynecol J. 2015. PMID: 25385662 Review.
-
Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review.Int J Colorectal Dis. 2013 Nov;28(11):1567-77. doi: 10.1007/s00384-013-1739-0. Epub 2013 Jul 31. Int J Colorectal Dis. 2013. PMID: 23900652 Free PMC article.
-
Triple-target treatment versus low-frequency electrostimulation for anal incontinence: a randomized, controlled trial.Dtsch Arztebl Int. 2011 Sep;108(39):653-60. doi: 10.3238/arztebl.2011.0653. Epub 2011 Sep 30. Dtsch Arztebl Int. 2011. PMID: 22013492 Free PMC article. Clinical Trial.
-
Kegel Exercises, Biofeedback, Electrostimulation, and Peripheral Neuromodulation Improve Clinical Symptoms of Fecal Incontinence and Affect Specific Physiological Targets: An Randomized Controlled Trial.J Neurogastroenterol Motil. 2021 Jan 30;27(1):108-118. doi: 10.5056/jnm20013. J Neurogastroenterol Motil. 2021. PMID: 33109777 Free PMC article.
References
References to studies included in this review
Fynes 1999 {published data only}
-
- Fynes MM, Marshall K, Cassidy M, Behan M, Walsh D, O'Connell PR, O'Herlihy C. A prospective, randomized study comparing the effect of augmented biofeedback with sensory biofeedback alone on fecal incontinence after obstetric trauma. Diseases of the Colon and Rectum 1999;42(6):753‐8; discussion 758‐61. [MEDLINE: ] - PubMed
Mahony 2004 {published data only}
-
- Mahony RT, Malone PA, Nalty J, Behan M, O'Connell PR, O'Herlihy C. Randomized clinical trial of intra‐anal electromyographic biofeedback physiotherapy with intra‐anal electromyographic biofeedback augmented with electrical stimulation of the anal sphincter in the early treatment of postpartum fecal incontinence. American Journal of Obstetrics & Gynecology 2004;191(3):885‐90. [19215] - PubMed
Norton 2006a {published data only}
-
- Norton C, Gibbs A, Kamm MA. Randomized, controlled trial of anal electrical stimulation for fecal incontinence. Diseases of the Colon & Rectum 2006;49(2):190‐6. [21601] - PubMed
Osterberg 2004 {published data only}
-
- Osterberg A, Edebol Eeg‐Olofsson K, Hallden M, Graf W. Randomized clinical trial comparing conservative and surgical treatment of neurogenic faecal incontinence. British Journal of Surgery 2004;91(9):1131‐7. [19250] - PubMed
References to studies excluded from this review
George 1991 {published data only}
-
- George BD, Patel J, Hallan RI, Watkins ES, Williams NS. Intermittent electrical stimulation of the gracilis neosphincter. British Journal of Surgery 1991;78(6):756. - PubMed
Sprakel 1998 {published data only}
-
- Sprakel B, Maurer M, Langer M, Diller R, Spiegel HU, Winde G. Effect of electrostimulation on sphincter function in fecal incontinence [Stellenwert der schwellstromtherapie im rahmen der konservativen behandlung der anorektalen inkontinenz]. Zentralblatt fur Chirurgie 1998;123:224‐229. - PubMed
Surh 1998 {published data only}
-
- Surh S, Kienle P, Stern J, Herfarth C. [Passive electrostimulation therapy of the anal sphincter is inferior to active biofeedback training]. [German] [Die passive Elektrostimulationstherapie des Analsphinkters ist dem aktiven Biofeedbacktraining unterlegen]. Langenbecks Archiv fur Chirurgie ‐ Supplement ‐ Kongressband 1998;115:976‐8. [MEDLINE: ] - PubMed
Williams 1991 {published data only}
-
- Williams NS, Patel J, George BD, Hallan RI, Watkins ES. Development of an electrically stimulated neoanal sphincter. Lancet 1991;338(8776):1166‐9. [MEDLINE: ] - PubMed
References to ongoing studies
Stott {published data only}
-
- A study to determine the effects of neuro‐stimulation on anal sphincter function when used in conjunction with biofeedback and pelvic floor exercises in the treatment of faecal incontinence. Ongoing study January 2000..
Additional references
Cheetham 2002
-
- Cheetham M, Brazzelli M, Norton C, Glazener CMA. Drug treatment for faecal incontinence in adults. Cochrane Database of Systematic Reviews 2002, Issue 3. [Art. No.: CD002116. DOI: 10.1002/14651858.CD002116] - PubMed
Haskell 1967
-
- Haskell B, Rovner H. Electromyography in the managment of the incompetent anal sphincter. Disease of the Colon and Rectum 1967;10(2):81‐4. [MEDLINE: ] - PubMed
Hay‐Smith 2006
-
- Hay‐Smith EJC, Dumoulin C. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2006, Issue 1. [Art. No.: CD005654. DOI: 10.1002/14651858.CD005654] - PubMed
Herold 1989
-
- Herold A, Bruch HP, Hocht B, Muller G. Biofeedback training and functional electrostimulation for improving incontinence in children with anal atresia. Langenbecks Archiv für Chirurgie. Supplement II, Verhandlungen der Deutschen Gesellschaft für Chirurgie. Deutsche Gesellschaft für Chirurgie. Kongress 1989;Supplement II:991‐5. - PubMed
Higgins 2005
-
- Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]. The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd, 2005, Issue 3.
Hudlicka 1982
-
- Hudlicka O, Dodd L, Renkin EM, Gray SD. Early changes in fiber profile and capillary density in long‐term stimulated muscles. American Journal of Physiology 1982;243:528‐35. - PubMed
Johanson 1996
-
- Johanson JF, Lafferty J. Epidemiology of faecal incontinence: the silent affliction. American Journal of Gastroenterology 1996;91(1):33‐6. - PubMed
Konsten 1995
-
- Konsten J, Geerdes B, Versluis P, Heineman E, Baeten GM. Dynamic graciloplasty for restoration of continence after traumatic destruction of the rectum and sphincters: report of a case. Journal of Trauma 1995;38(1):11‐3. [MEDLINE: ] - PubMed
Laycock 2002
-
- Laycock J, Haslam J. Therapeutic management of incontience and pelvic pain. London: Springer, 2002.
Madoff 2005
-
- Madoff RD, Pemberton JH, Mimura T, Laurberg S. Surgery for fecal incontinence. In: Abrams P, Cardoza L, Khoury S, Wein A editor(s). Incontinence: 3rd International Consultation on Incontinence. Plymouth: Health Publications, 2005:1565‐88.
Norton 2004
-
- Norton C, Chelvanayagam S. Bowel Continence Nursing. Beaconsfield: Beaconsfield Publishers, 2004.
Norton 2005
-
- Norton C, Whitehead WE, Bliss DZ, Metsola P, Tries J. Conservative and pharmacological management of faecal incontinence in adults. In: Abrams P, Cardoza L, Khoury S, Wein A editor(s). Incontinence. Plymouth: Health Publications, 2005:1521‐63.
Norton 2006b
-
- Norton C, Cody JD, Hosker G. Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database of Systematic Reviews 2006, Issue 3. [Art. No.: CD002111. DOI: 10.1002/14651858.CD002111.pub2] - PubMed
Perry 2002
Potter 2002
-
- Potter J, Norton C, Cottenden A. Bowel care in older people. London: Royal College of Physicians, 2002.
Rockwood 1999
-
- Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Disease of the Colon and Rectum 2000;43:9‐17. - PubMed
Rockwood 2000
-
- Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, et al. Fecal incontinence quality of life scale. Diseases of the Colon and Rectum 2000;43:9‐17. - PubMed
Salmons 1969
Tuteja 2004
-
- Tuteja AK, Rao SS. Review article: recent trends in diagnosis and treatment of faecal incontinence. Alimentary Pharmacol Therapy 2004;19(8):829‐40. - PubMed
Wade 1988
-
- Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability. International Disabilities Studies 1988;10(2):64‐7. [MEDLINE: ] - PubMed
Ware 1993
-
- Ware JE, Sherbourne CD. SF‐36 Health Survey Manual and Interpretation Guide. Boston: New England Medical Centre, 1993.
Weinstein 1977
-
- Weinstein MC, Statson WB. Foundations of cost‐effectiveness analysis for health and medical practices. New England Journal of Medicine 1977;296(13):716‐21. [MEDLINE: ] - PubMed
Whitehead 2001
-
- Whitehead WE, Wald A, Norton N. Treatment options for fecal incontinence: consensus conference report. Diseases of the Colon and Rectum 2001;44:131‐44. - PubMed
Wilson 2005
-
- Wilson PD, Berghmans B, Hagen S, Hay‐Smith J, Moore K, Nygaard I. Adult conservative management. In: Abrams P, Cardoza L, Khoury S, Wein A editor(s). Incontinence: 3rd International Consultation on Incontinence. Plymouth: Health Publications, 2005:5‐964.
Zigmond 1983
-
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 1983;67(6):361‐70. [MEDLINE: ] - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources