title: Penile and clitoral stimulation for faecal incontinence: external application of a bipolar electrode for patients with faecal incontinence.
abstract: OBJECTIVE
  The aim of this study was to assess the effect of a novel pudendal nerve stimulator on clinical and anorectal manometric parameters in patients with faecal incontinence.
  
  
  METHODS
  Retrospective cohort analysis of consecutive patients presenting with faecal incontinence who had failed initial conservative treatment and were not suitable for surgical intervention in a university hospital incontinence clinic. Biofeedback using a pudendal nerve stimulator comprising a bipolar electrode applied to the base of the clitoris or penis. Electrical pulse voltage was self-titrated and defined periods of treatment were prescribed. Anorectal manometry and Cleveland incontinence scores were assessed.
  
  
  RESULTS
  There was a significant reduction in incontinence symptom score after pudendal nerve stimulator treatment in the 42 patients treated and who had a complete set of data (median age 57 years (range 37-81); 39 female, 3 male). This was accompanied by significant improvements (P < 0.05) in anal sphincter tone, maximal tolerated rectal volume and the sustained rectoanal inhibitory reflex.
  
  
  CONCLUSIONS
  An externally applied pudendal nerve stimulator improves symptoms and physiological evidence of faecal incontinence but long-term follow up is not available for these patients.
authors.affiliation: Department of Colorectal Surgery, Christchurch Hospital, Christchurch, New Zealand. frank.frizelle@chmeds.ac.nz
authors.forename: F A
authors.initials: FA
authors.lastname: Frizelle
authors.forename: R B
authors.initials: RB
authors.lastname: Gearry
authors.forename: M
authors.initials: M
authors.lastname: Johnston
authors.forename: M L
authors.initials: ML
authors.lastname: Barclay
authors.forename: B R
authors.initials: BR
authors.lastname: Dobbs
authors.forename: C
authors.initials: C
authors.lastname: Wise
authors.forename: W D
authors.initials: WD
authors.lastname: Troughton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000502:physiology; D002987:Clitoris / Q000294:innervation*; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D005242:Fecal Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010413:Penis / Q000294:innervation*; D012189:Retrospective Studies; D016896:Treatment Outcome