Neuromodulación de raíces sacras como tratamiento de la incontinencia fecal: Resultados preliminares

Navarro, J. M.; Sebastián, Antonio Arroyo; Vicente, F Pérez; Romero, Alberto; Legaz, J. Pérez; Paz, P. Serrano; Frias, Altino; Polo, Fernando; Rico, Rafael Calpena

doi:10.4321/s1130-01082007001100003

Cited by 8 publications

(1 citation statement)

References 27 publications

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“…Anal incontinence is defined as the involuntary and recurrent passage of stool or flatus through the anal canal (1)(2)(3) . Its etiology is multifactorial; the disorder has a significant impact on the quality of life due to physical and psychological impairments (4)(5)(6) .…”

Section: Introductionmentioning

confidence: 99%

Functional and Anatomical Analysis of the Anorectum of Female Scleroderma Patients at a Center for Pelvic Floor Disorders

Pinto

Neto

Nahas

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: Scleroderma or progressive systemic sclerosis is characterized by a chronic inflammatory process with proliferation of fibrous connective tissue and excessive deposition of collagen and extracellular matrix in the skin, smooth muscle, and viscera. The smooth muscle most involved in scleroderma is that of the esophagus, and dysphagia is the most commonly reported symptom. However, the internal anal sphincter may also be impaired by degeneration and fibrosis, leading to concomitant anal incontinence in scleroderma patients. These patients may neglect to complain about it, except when actively questioned. OBJECTIVE: To assess anorectal function and anatomy of female scleroderma patients with symptoms of anal incontinence through Cleveland Clinic Florida Fecal Incontinence Score (CCFIS), anorectal manometry and endoanal ultrasound at the outpatient clinic of colorectal and anal physiology, Clinics Hospital, University of São Paulo Medical School (HC-FMUSP). METHODS: Female scleroderma patients were prospectively assessed and questioned as to symptoms of anal incontinence. The anorectal manometry and endoanal ultrasound results were correlated with clinical data and symptoms. RESULTS: In total, 13 women were evaluated. Their mean age was 55.77 years (±16.14; 27-72 years) and their mean disease duration was 10.23 years (±6.23; 2-23 years). All had symptoms of fecal incontinence ranging from 1 to 15. Seven (53.8%) patients had fecal incontinence score no higher than 7; three (23.1%) between 8 and 13; and three (23.1%) 14 or higher, corresponding to mild, moderate, and severe incontinence, respectively. Ten (76.92%) patients had hypotonia of the internal anal sphincter. Three-dimensional endoanal ultrasound showed tapering associated with muscle atrophy of the internal sphincter in six cases and previous muscle defects in three cases. CONCLUSION: A functional and anatomical impairment of the sphincter is an important factor to assess in patients with progressive systemic sclerosis and it should not be underestimated.

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Section: Introductionmentioning

confidence: 99%

Functional and Anatomical Analysis of the Anorectum of Female Scleroderma Patients at a Center for Pelvic Floor Disorders

Pinto

Neto

Nahas

et al. 2018

Arq. Gastroenterol.

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Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence

Thin¹,

Horrocks²,

Hotouras³

et al. 2013

British Journal of Surgery

184

121

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Emerging data for SNS suggest maintenance of its initial therapeutic effect into the long term. The clinical effectiveness of PTNS is comparable to that of SNS at 12 months, although there is no evidence to support its continued effectiveness after this period. PTNS may be a useful treatment before SNS. The clinical effectiveness of TTNS is still uncertain owing to the paucity of available evidence. A consensus to standardize the use of outcome measures is recommended in order that further reports can be compared meaningfully.

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Benign Anal Disease: Who Are the Right Candidates for Sacral Nerve Stimulation?

Rice

Paquette

2017

Difficult Decisions in Colorectal Surgery

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Neuromodulación de raíces sacras como tratamiento de la incontinencia fecal: Resultados preliminares

Cited by 8 publications

References 27 publications

Functional and Anatomical Analysis of the Anorectum of Female Scleroderma Patients at a Center for Pelvic Floor Disorders

Functional and Anatomical Analysis of the Anorectum of Female Scleroderma Patients at a Center for Pelvic Floor Disorders

Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence

Benign Anal Disease: Who Are the Right Candidates for Sacral Nerve Stimulation?

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