Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a systematic literature review

Desprez, Charlotte; Turmel, Nicolas; Chesnel, C.; Mistry, Pramod K.; Tamiatto, M.; Haddad, Rebecca; Breton, F. Le; Leroi, A.-M.; Hentzen, Claire; Amarenco, G.

doi:10.1007/s00384-020-03803-8

Cited by 6 publications

(9 citation statements)

References 43 publications

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“…Saldana Ruiz et al (2017) revealed a prevalence of 8.4% of FI in non-institutionalized adults in the United States, with an increase in this percentage dependent on age over time [ 6 ]. Similar data was obtained in United Kingdom (4.9–13.3% of people over 64 years [ 7 ], 11–15% in adults [ 8 ], and 7.9% in Dutch population [ 9 ]). Although, to date, we do not have official Spanish data, the doctoral thesis of Yolanda Maestre González in 2013 estimated a 10.8% of FI in the population studied in Barcelona [ 10 ].…”

Section: Introductionsupporting

confidence: 82%

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review

Ibáñez-Vera

Mondéjar-Ros²,

Franco-Bernal

et al. 2022

JCM

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Fecal incontinence is a condition that carries high social stigmatization and a determining factor in the quality of life of the person who suffers from it. Its etiology is multifactorial and treatment includes surgical and conservative measures, including stimulation of the posterior tibial nerve. The aim of this review is to determine whether posterior tibial nerve stimulation (PTNS) is more effective than other treatments in reducing episodes of fecal incontinence in adults. A systematic review of randomized clinical trials that analyzed different approaches and comparisons with other treatments in adults without neurological or metabolic diseases was carried out, analyzing, fundamentally, the reduction of episodes of fecal incontinence. In general, a reduction in fecal incontinence episodes is observed in the experimental groups compared with the control groups, although these differences are not significant in most studies. The results regarding the effectiveness of PTNS in reducing episodes of fecal incontinence compared to other treatments are not entirely conclusive, although benefits are observed regarding the stimulation of sacral roots. More well-designed studies with a long-term follow-up of the results are needed so that the recommendation of this treatment can be generalized.

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Section: Introductionsupporting

confidence: 82%

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review

Ibáñez-Vera

Mondéjar-Ros²,

Franco-Bernal

et al. 2022

JCM

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“…In general, there is difficulty in stratifying FI patients into subgroups. A review 43 stated that several anorectal manometry studies for subtypes of FI exist but with discrepancy among results and mixed phenotypes of FI seems to be neglected. Furthermore, classification based on clinical presentation of FI may be oversimplified and symptoms may overlap 44 .…”

Section: Discussionmentioning

confidence: 99%

Fecobionics characterization of female patients with fecal incontinence

Futaba

Chen

Leung

et al. 2022

Sci Rep

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Defecatory disorders including fecal incontinence (FI) are diagnosed on the symptom pattern supplemented by anorectal manometry (ARM), the balloon expulsion test (BET), and endo-anal ultrasonography. In this study, we used a simulated stool named Fecobionics to study distinct defecation patterns in FI patients using preload-afterload diagrams and to provide comparative data on defecation indices (DIs) between passive and urge incontinent patients. All subjects had Fecobionics, endo-anal ultrasonography and ARM-BET done. The Fecobionics bag was distended in rectum until urge in 37 female patients (64.1 ± 1.5 yrs) and a group of normal subjects (NS, 12F, age 64.8 ± 2.8 yrs). Rear-front pressure (preload-afterload) diagrams and DIs were compared between groups. The FISI score in the patients was 8.6 ± 0.6. The NS did not report FI-related symptoms. All patients and NS defecated Fecobionics and ARM-BET within 2 min. The urge volume was 46.1 ± 3.6 and 35.3 ± 5.9 mL in the FI and normal groups (P > 0.1). The expulsion duration was 14.8 ± 2.4 and 19.8 ± 5.1 s for the two groups (P > 0.1). The preload-afterload diagrams demonstrated clockwise loops that clearly differed between the FI subtypes and NS. The DIs showed profound difference between patients and NS. Fecobionics data showed higher correlation with symptoms in FI patients than ARM-BET. Fecobionics obtained novel pressure signatures in subtypes of FI patients and NS. Fecobionics provides DI data that cannot be obtained with ARM-BET.

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“…Previous studies have not demonstrated a clear association between FI subtype and anal sphincter dysfunction [3]. This could be due to a lack of sensitivity of current anorectal investigations (i.e.…”

Section: Introductionmentioning

confidence: 93%

“…This condition is classified by the International Continence Society (ICS) into two subtypes: urge incontinence, defined as the unwanted loss of stool despite active attempts to inhibit defaecation, and passive incontinence, defined as unwanted loss of stool without patient awareness [ 2 ]. However, a third subtype, mixed FI, is also described in many studies and is defined as a combination of urge and passive FI [ 3 ]. This subtype may be related to the underlying pathophysiological mechanisms responsible for FI and may serve as a guide for first‐line therapeutics [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between anal functional lumen imaging probe (EndoFLIP®) results and the clinical presentation of faecal incontinence

et al. 2022

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Aim Faecal incontinence (FI) subtypes (urge, passive, mixed) are linked to the physiopathological mechanism of FI. Previous studies have failed to demonstrate a consistent relationship between FI subtype and anal sphincter dysfunction. Our aim was to evaluate the relationship between anal sphincter function, assessed using the new EndoFLIP® technology, and FI subtype. Method Patients referred for FI were prospectively enrolled between October 2015 and May 2021 in a registry, and data were retrospectively examined. Each patient underwent a clinical assessment as well as three‐dimensional high‐resolution or water‐perfused anorectal manometry, anal EndoFLIP®, and anorectal electrophysiological and endoanal ultrasound tests. The results of the investigations were compared across FI subtypes. Results The cohort included 133 patients, 54 (41%) of whom met the criteria for urge FI, 40 (30%) for passive FI and 39 (29%) for mixed FI. The resting anal distensibility index (DI) at 50 ml of distension was significantly lower in patients with urge FI than in patients with passive FI (p = 0.04). At rest, a DI at 50 ml of distension ≥7.3 mm2 mmHg−1 and a DI at 40 ml of distension <1.3 mm2 mmHg−1 were associated with the passive and urge FI subtypes, respectively, with poor discriminatory power (an accuracy of 0.49 compared with 0.33 for random assignment). There were no differences in anorectal manometry, endoanal ultrasound or electrophysiological test results among the urge, passive and mixed FI subgroups (all p > 0.05). Conclusion The anal sphincter DI using the EndoFLIP® system displayed poor predictive performance in distinguishing among FI subtypes.

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Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a systematic literature review

Cited by 6 publications

References 43 publications

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review

Efficacy of Posterior Tibial Nerve Stimulation in the Treatment of Fecal Incontinence: A Systematic Review

Fecobionics characterization of female patients with fecal incontinence

Relationship between anal functional lumen imaging probe (EndoFLIP®) results and the clinical presentation of faecal incontinence

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