title: A prospective non-randomized two-centre study of patients with passive faecal incontinence after birth trauma and patients with soiling after anal surgery, treated by elastomer implants versus rectal irrigation.
abstract: OBJECTIVE
  This study is a prospective evaluation of patients with passive faecal incontinence and patients with soiling treated by elastomer implants and rectal irrigation.
  
  
  METHODS
  Patients with passive faecal incontinence after birth trauma resulting from a defect of the internal sphincter and patients with soiling after previous anal surgery were included. All patients underwent endo-anal ultrasound, magnetic resonance imaging, and anal manometry. The patients with passive faecal incontinence were initially treated by anal sphincter exercises and biofeedback therapy during half a year. The patients completed incontinence scores, a quality of life questionnaire, and a 2-week diary card.
  
  
  RESULTS
  The elastomer group consisted of 30 males and 45 females with a mean age of 53 years (25-77). The rectal irrigation group consisted of 32 males and 43 females with a mean age of 50 years (25-74). At 6 months follow-up, 30 patients with soiling of the rectal irrigation group and only nine patients of the elastomer group were completely cured (p = 0.02). Only three patients with passive faecal incontinence were cured in the rectal irrigation group and none in the elastomer group. Three distal migrations of elastomer implants required removal at follow-up.
  
  
  CONCLUSIONS
  After patients had performed anal sphincter exercises, no clear improvement of passive faecal incontinence was obtained by elastomer implants or rectal irrigation. However, rectal irrigation is far more effective than elastomer implants in patients with soiling.
authors.affiliation: Department of Surgery, University Hospital of Maastricht, Stadskanaal, the Netherlands. s.vanderhagen@refaja.nl
authors.forename: S J
authors.initials: SJ
authors.lastname: van der Hagen
authors.forename: W
authors.initials: W
authors.lastname: van der Meer
authors.forename: P B
authors.initials: PB
authors.lastname: Soeters
authors.forename: C G
authors.initials: CG
authors.lastname: Baeten
authors.forename: W G
authors.initials: WG
authors.lastname: van Gemert
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D020724:Elastomers / Q000627:therapeutic use*; D005242:Fecal Incontinence / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036801:Parturition; D011446:Prospective Studies; D019736:Prostheses and Implants; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D020724:Elastomers