Extended two-year results of radio-frequency energy delivery for the treatment of fecal incontinence (the Secca procedure).
OBJECTIVE
This study evaluated the durability and long-term safety of radio-frequency energy delivery for fecal incontinence (Secca procedure).


METHODS
This was an extended follow-up of a prospective study in which patients with fecal incontinence of various causes underwent radio-frequency energy delivery to the anal canal muscle. The Cleveland Clinic Florida Fecal Incontinence Scale (0-20), fecal incontinence-related quality-of-life score, and Medical Outcomes Study Short Form 36 were administered at baseline and at 1, 2, 3, 6, 12, and 24 months after the procedure. Differences between baseline and follow-up were analyzed with the Wilcoxon signed-rank test.


RESULTS
Ten females (aged 55.9 +/- 9.2 (range, 44-74) years) were treated. At two-year follow-up, the mean Cleveland Clinic Florida Fecal Incontinence Scale score was improved from 13.8 to 7.3 (P = 0.002), with eight patients having scores of < or =10. All fecal incontinence-related quality-of-life score parameters were improved, including lifestyle (from 2.3 to 3.3; P = 0.002), coping (from 1.7 to 2.7; P = 0.002), depression (from 2.4 to 3.4; P = 0.004), and embarrassment (from 1.5 to 2.4; P = 0.008). There was no decrement in effect noted in any parameter between 12 and 24 months (P > 0.2). The social function component of the Short Form 36 improved from 50 to 82.5 (P = 0.04), whereas there was an improvement trend for the mental component summary of the Short Form 36 from 38.3 to 48.1 (P = 0.11). Protective pad use was eliminated in four of the seven baseline users. There were no long-term complications, such as stricture, pain, or constipation.


CONCLUSIONS
A significant improvement in symptoms of fecal incontinence and quality of life persists two years after radio-frequency delivery to the anal canal, which demonstrates durability of this intervention.
Takahashi
Takeshi
T
Service of Colon and Rectal Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
Garcia-Osogobio
Sandra
S
Valdovinos
Miguel A
MA
Belmonte
Carlos
C
Barreto
Camilo
C
Velasco
Liliana
L
D000328:Adult; D000368:Aged; D003972:Diathermy; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome