[The anal plug in the treatment of fecal incontinence in myelomeningocele patients: results of the first clinical trial].
OBJECTIVE
Ninety percent of patients with myelomeningocele are affected by urinary incontinence and more than 75% suffer fecal incontinence as well. For this reason, we carried out a clinical trial in order to demonstrate the performance of the anal plug.


METHODS
The trial was carried out with 19 patients, 10 females and 9 males, between 3 and 26 years of age. Fecal incontinence was considered to be a problem in 94.7%. The anal plug used was made of polyurethane foam compressed by a polyvinyl alcohol foil that dissolves when exposed to warmth and moisture, expanding to its full size in 30-60 seconds. The anal plug is removed by pulling gently on a soft gauze string that is molded into the plug.


RESULTS
The maximum time of having the anal plug in place was 12 hours. The reason for removal was due to routine change in 57.9% of the cases and in 21% the product slipped out, mainly during the adaptation and training period. Application of the anal plug was found to be very easy by 73.6% of the patients. The general evaluation was excellent to good in 78.9% of the users and 89.5% of the patients wished to continue using the product.


CONCLUSIONS
Having clinically evaluated the effectiveness of the anal plug, we can conclude that the use of this product provides clear physical and psychological benefits. To date, it is the only non-surgical treatment for fecal incontinence available to those patients who desire to carry out a complete social life.
Sánchez Martín
R
R
Sección de Urología Pediátrica, H.G.U. Gregorio Marañón, Madrid.
Barrientos Fernndez
G
G
Arrojo Vila
F
F
Vázquez Estévez
J J
JJ
D000293:Adolescent; D000328:Adult; D001003:Anal Canal; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005242:Fecal Incontinence / Q000150:complications* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D011140:Polyurethanes / Q000627:therapeutic use; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016896:Treatment Outcome
D011140:Polyurethanes; C028279:polyurethane foam