Electrophysiological Basis of Fecal Incontinence and Its Implications for Treatment

Weledji, Elroy Patrick

doi:10.3393/ac.2017.33.5.161

Cited by 14 publications

(13 citation statements)

References 75 publications

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“…The internal anal sphincter and the rectum are controlled by the parasympathetic and sympathetic sacral nerves, while the external anal sphincter muscle is controlled by the vulva nerve [ 21 ]. The sympathetic system stimulates muscular contraction (i.e., closure of the rectum), while the parasympathetic system relaxes the muscles, allowing for defecation [ 22 ]. The sphincter mechanism reacts differently, depending on the consistency of the stool, as during defecation and anal stretching, the sensory receptors are irritated.…”

Section: Introductionmentioning

confidence: 99%

Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women—Systematic Review of Methods

Mazur-Biały

Kołomańska-Bogucka

Opławski³

et al. 2020

JCM

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Fecal incontinence (FI) affects approximately 0.25–6% of the population, both men and women. The most common causes of FI are damage to/weakness of the anal sphincter muscle and/or pelvic floor muscles, as well as neurological changes in the central or peripheral nervous system. The purpose of this study is to report the results of a systematic review of the possibilities and effectiveness of physiotherapy techniques for the prevention and treatment of FI in women. For this purpose, the PubMed, Embase, and Web of Science databases were searched for 2000–2020. A total of 22 publications qualified for detailed analysis. The studies showed that biofeedback (BF), anal sphincter muscle exercises, pelvic floor muscle training (PFMT), and electrostimulation (ES) are effective in relieving FI symptoms, as reflected in the International Continence Society recommendations (BF: level A; PFMT and ES: level B). Research has confirmed that physiotherapy, by improving muscle strength, endurance, and anal sensation, is beneficial in the prevention of FI, both as an independent method of conservative treatment or in pre/post-surgery treatment. Moreover, it can significantly improve the quality of life of patients. In conclusion, physiotherapy (in particular, BF, PFMT, or ES, as effective methods) should be one of the key elements in the comprehensive therapy of patients with FI.

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Section: Introductionmentioning

confidence: 99%

Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women—Systematic Review of Methods

Mazur-Biały

Kołomańska-Bogucka

Opławski³

et al. 2020

JCM

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“…A degree of detrusor instability is found in many normal people if subjected to careful urodynamic studies. Weak sphincters as a result of surgical or nerve injury (Schofield, , Weledji, ) and the descending urethra in stress incontinence would also manifest as loss of control (Blandy, ). A history of coexisting anorectal (fecal) incontinence suggests neuropathic (pudendal nerve) injury to the external urethral and external anal sphincters and levator ani, which can therefore be suitable for sacral nerve (S2‐4) stimulation (SNS) (Weledji, ; McGee et al, ) (Figs.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous tibial nerve stimulation (PTNS) is a less invasive, less direct and less expensive method for neuromodulation, which has also proved effective in several randomized and non‐randomized trials, including improvement rates comparable to anti‐cholinergics in OAB management. However, PTNS remains effective only for a short period after the stimulation is delivered (Weledji, ; Abello and Das, ). This technique has a much lower rate of adverse events than SNS, but with the inconvenience of weekly visits for stimulation, although implantable devices are on the horizon (Gupta et al, ).…”

Section: Discussionmentioning

confidence: 99%

The anatomy of urination: What every physician should know

2018

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Normal voiding needs a coordinated, sustained bladder contraction of adequate size and duration. It requires a decrease in resistance of the bladder neck and urethra and no obstruction. Voiding problems can arise from abnormal storage of urine or problems with urinary control. The aim of this article was to review the functional anatomy and physiology of urinary control and micturition and the pathophysiology of urinary control problems. The Medline (PubMed) database, Cochrane Library, and Science Citation Index were searched electronically to identify original published studies on bladder anatomy, function and urinary control. References were searched from relevant chapters in specialized texts and all were included. Voiding problems are the most common presenting urological symptoms in general medical practice. Urinary incontinence occurs when the normal process of storing and passing urine is disrupted. A history of coexisting fecal incontinence suggests a neuropathic etiology. A better understanding of the physiology of urinary control could lead to preventive measures for postoperative urinary retention and incontinence such as fluid restriction and to appropriate anesthesia/analgesia, autonomic nerve preservation, total mesorectal excision (TME) for rectal cancer, and biofeedback exercises. It could also suggest appropriate therapeutic measures for established urinary incontinence. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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“…SNM was approved for use in the management of FI by the FDA in 2011 ( Figure 3). SNM works by electrical stimulation of the sacral nerve roots, producing anal sphincter augmentation and modulation of spinal/supraspinal pathways 29 . Wexner et al .…”

Section: Introductionmentioning

confidence: 99%

Recent advances in managing fecal incontinence

Silva

Sirany

2019

F1000Res

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Fecal incontinence (FI) is the uncontrolled passage of feces or gas in an individual who previously had control. The prevalence of the problem varies but can be as high as 50% of institutionalized individuals. The severity varies among individuals, but the negative impact on self-esteem and quality of life can have devastating effects. The goals of treatment are to decrease the frequency and severity of episodes as well as to improve quality of life. At present, several therapies, ranging from medical management to more invasive surgical interventions, are offered for the management of FI. In this article, we review the most recent advances in the management of FI.

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Electrophysiological Basis of Fecal Incontinence and Its Implications for Treatment

Cited by 14 publications

References 75 publications

Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women—Systematic Review of Methods

Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women—Systematic Review of Methods

The anatomy of urination: What every physician should know

Recent advances in managing fecal incontinence

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