A new polyurethane anal plug in the treatment of incontinence after anal atresia repair.
38 totally or partially incontinent patients following imperforate anus repair (age 6-15 years) tested a new polyurethane (PU) anal plug against another, widely used anal plug (PVA) in a randomized crossover trial. Plugs were tested 3 weeks each, data concerning bowel habits, handling and plug-related problems were collected by questionnaire before trial, at time of product change and after trial.


RESULTS
15 of 38 patients did not complete the protocol, among them 6 with anal canal diameters too small for the smallest plug. During plug use, patients experienced enhanced awareness of repletion and urge. Stool consistence did not change in 82% of patients. There were no changes in children constipated prior to study (n = 8/23). 12,123 children were absolutely clean during use of either plug. 15 patients (68%) using the PU plug and 10 (45%) using the PVA plug felt secure from soiling during plug use. 74% of patients preferred the PU plug. Painful plug insertion, a feeling of pressure inside the anal canal and painful plug removal were reported with both plugs, but were less frequent with the PU plug.


CONCLUSIONS
Anal plugs, regardless of their make, offer absolute cleanliness for periods of several hours to 66% of our incontinent patients. The PU plug (Conveen, Coloplast) is preferred by the patients and offers greater security than the PVA plug.
Pfrommer
W
W
Department of Pediatric Surgery, Kinderkrankenhaus der Stadt Köln, Cologne, Germany.
Holschneider
A M
AM
Löffler
N
N
Schauff
B
B
Ure
B M
BM
D000293:Adolescent; D001006:Anus, Imperforate / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D018592:Cross-Over Studies; D005242:Fecal Incontinence / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D017060:Patient Satisfaction; D011140:Polyurethanes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000534:rehabilitation*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D011140:Polyurethanes