Effective and safe control of incontinence by the intra-anal plug electrode

Abstract

A régime is described for treatment of urinary and faecal incontinence by the intra‐anal plug electrode, giving results in 30 patients. Therapy is safe, inexpensive, and involves the minimum of hospital or general practitioner supervision. Positioning and control are easy with the modified electrode. Stimulation causes no appreciable discomfort in most patients. Possible modes of action are discussed and it is suggested that stimulation works by strengthening levator tone rather than local sphincters. Perineal awareness is enhanced, making conscious muscle contraction easier in exercises. Greater use should be made of this device.

Electrical pelvic floor stimulation for the control of detrusor instability

“…To begin with, mainly stress incontinence was treated, either primary or recurrent. On the whole, the results were fair to good [Alexander et al, 1970;Caldwell et al, 1968;Collins, 1973;Edwards and Malvern, 1972;Fall et al, 1978c;Glen, 1967;Kralj, 1981;Moore and Schoofield, 19671. A favourable unexpected effect was that some patients remained continent after withdrawal of stimulation, a phenomenon called reeducation.…”

“…1). [Collins, 1973;Doyle et al, 1974;Glen, 1967;Hopkinson, 1972;Merrill et al, 1975;Sotiropoulus, 19751. The shape of the electrodes has not been subject to great variation.…”

“…Direct high-intensity stimulation of pelvic floor structures was also effective in stress urinary incontinence [Moore and Schoofield, 19671. It was subsequently found that external electrical stimulation was as effective in the treatment of urinary incontinence [Alexander et al, 1970;Collins, 1973;Glen, 1967;Harrison, 1971 ;Hoplunson and Lightwood, 1967;Merrill et al, 19751. The use of implanted devices has now been almost abandoned since the surgical procedures are complicated.…”

Use of a neuromuscular stimulator to increase anal sphincter pressure

“…In other studies, pain/sensation can limit the duration of stimulation and the maximal current. 7,12 As our study evaluated surface electrical stimulation in a group of complete SCI individuals, local pain/sensation was not a limiting factor. We were able to evaluate high current.…”

Konservative Therapiemöglichkeiten der fäkalen Inkontinenz

“…Mittlerweile sind zahlreiche Untersuchungen an gemischten Patientenkollektiven durchgeführt worden. Bei bis zu zwei Drittel der Patienten konnte eine klinische und manometrische Besserung erreicht werden [17][18][19][20][21]. Über die Behandlungsintensität und -länge gibt es keine einheitlichen Angaben.…”