Defining the histopathological changes induced by nonablative radiofrequency treatment of faecal incontinence – a blinded assessment in an animal model

Herman, R. M.; Berho, Mariana; Murawski, M.; Nowakowski, Michał; Ryś, Janusz; Schwarz, Thomas; Wojtysiak, Dorota; Wexner, Steven D.

doi:10.1111/codi.12874

Cited by 31 publications

(21 citation statements)

References 30 publications

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“…It follows a principle that already exists, but applied in a different way. We applied the technique on the urethral meatus after an animal experimental study has demonstrated the possibility of increasing collagen production of anal sphincter ( 9 ) and we used temperatures ranging from 39 to 41°C, as it was proved to be safe and effective in the human genital region ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…A current treatment proposal is the use of radiofrequency, which is a diathermic process generated by the radiation of an electromagnetic spectrum, resulting in an immediate retraction of existing collagen and subsequent activation of fibroblasts causing neocollagenesis ( 9 ). In studies using radiofrequency to treat SUI, a therapeutic response of 50% was shown ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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New concept for treating female stress urinary incontinence with radiofrequency

et al. 2017

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Purpose:To evaluate the clinical response and adverse effects of radiofrequency on the urethral meatus in the treatment of stress urinary incontinence in women.Materials and Methods:This phase one study included ten women with Stress Urinary Incontinence (SUI). The evaluation consisted of 1 hour Pad tests to quantify urine loss and to assess the degree of procedure satisfaction by using the Likert scale. To evaluate safety, we observed the number of referred side effects.Results:Average age was 53.10 years±7.08 years. In assessing the final Pad Test, 70% showed a reduction and 30% a worsening of urinary loss. Using the Pad Test one month later, there was a reduction in all patients (p=0.028). The degree of satisfaction was 90% and no side effects have been observed. One patient reported burning sensation.Conclusion:The treatment of SUI with radiofrequency on the urethral meatus has no adverse effects, being a low risk method that reduces urinary loss in women. However, to increase the validity of the study, larger clinical trials are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

New concept for treating female stress urinary incontinence with radiofrequency

et al. 2017

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“…Initial assumptions about scarification were erroneous. In contrast to the initial belief that protein denaturation would simply cause scarring and tightening of the tissue, new histologic assessment of tissue treated with RF remodeling revealed that nonablative RF treatment induces morphologic changes in the sphincter complex causing damaged sphincter muscle to become more normal appearing [23]. Numerous other salutary histopathologic and cellular-level structural changes were noted.…”

Section: Radiofrequency Therapymentioning

confidence: 86%

Current surgical strategies to treat fecal incontinence

Wexner

Bleier

2015

Expert Review of Gastroenterology & Hepatology

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Fecal incontinence is a devastating condition, vastly under-reported, and may affect up to 18% of the population. While conservative management may be efficacious in a large portion of patients, those who are refractory will likely benefit from appropriate surgical intervention. There are a wide variety of surgical approaches to fecal incontinence management, and knowledge and experience are crucial to choosing the appropriate procedure and maximizing functional outcome while minimizing risk. In this article, we provide a comprehensive description of surgical options for fecal incontinence to help the clinician identify an appropriate intervention.

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“…In particular, RF energy results in vibration of water molecules and subsequent frictional heating when delivered to a tissue in the frequency range of 200 kHz to 3.3 MHz [ 9 – 11 ]. Application of SECCA procedure in an animal model appeared to induce morphological changes in the internal and external anal sphincters leading to an anatomical state reminiscent of normal sphincter structure [ 12 ]. Thus, the SECCA procedure provides the release of temperature/impedance controlled RF energy to the sphincteric complex of the anal canal.…”

Section: Introductionmentioning

confidence: 99%

SECCA procedure for anal incontinence and antibiotic treatment: a case report of anal abscess

et al. 2018

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BackgroundFecal Incontinence (FI) can seriously affect quality of life. The treatment of fecal incontinence starts conservatively but in case of failure, different surgical approaches may be proposed to the patient. Recently several not invasive approaches have been developed. One of these is the radiofrequency (RF) energy application to the internal anal sphincter.Case presentationWe report a rare case of an anal abscess related to a SECCA procedure in a 66-year-old woman affected by gas and FI for twenty years.ConclusionsThe complications post-SECCA procedure reported in literature are generally not serious and often self-limited, such as bleeding or anal pain. This is a case of an anal abscess.We suggest that this finding could consolidate the importance of administering antibiotic therapy to patients and to run a full course of at least 6 days rather than a short-term (24 h) therapy, with the aim to minimize the incidence of this complication.

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Defining the histopathological changes induced by nonablative radiofrequency treatment of faecal incontinence – a blinded assessment in an animal model

Abstract: In an animal model nonablative RF appeared to induce morphological changes in the IAS and EAS leading to an anatomical state reminiscent of normal sphincter structure.

Cited by 31 publications

References 30 publications

New concept for treating female stress urinary incontinence with radiofrequency

New concept for treating female stress urinary incontinence with radiofrequency

Current surgical strategies to treat fecal incontinence

SECCA procedure for anal incontinence and antibiotic treatment: a case report of anal abscess

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