title: Home electrical stimulation for women with fecal incontinence: a preliminary randomized controlled trial.
abstract: OBJECTIVE
  The purpose of this study is to compare the effectiveness and cost of home electrical stimulation and standardized biofeedback training in females with fecal incontinence
  
  
  METHODS
  Thirty-six females suffering from fecal incontinence were randomized into two groups, matched for mean age (67.45 ± 7.2 years), mean body mass index (kg/m2) (26.2 ± 3.9), mean disease duration (4.1 ± 0.8 years), mean number of births (2.7 ± 1.3), and reports of obstetric trauma (25%). Questionnaires were used to evaluate their demographics, medical, and childbearing history. Subjects were randomized to home electrical stimulation or standardized biofeedback training for a period of 6 weeks. Subjective outcome measures included the frequency of fecal, urine, and gas incontinence by visual analog scale, Vaizey incontinence score, and subjects' levels of fecal incontinence related anxiety. Objective outcome measures included pelvic floor muscle strength assessed by surface electromyography. We also compared the cost of each treatment modality.
  
  
  RESULTS
  Only females who received home electrical stimulation (HES) reported a significant improvement in Vaizey incontinence score (p = 0.001), anxiety (p = 0.046), and in frequency of leaked solid stool (p = 0.013). A significant improvement in pelvic floor muscle strength was achieved by both groups. HES was much cheaper compared to the cost of standardized biofeedback training (SBT) (US $100 vs. US $220, respectively). Our study comprised a small female population, and the study endpoints did not include objective measures of anorectal function test, such as anorectal manometry, before and after treatment.
  
  
  CONCLUSIONS
  Home electrical stimulation may offer an alternative to standardized biofeedback training as it is effective and generally well-tolerated therapy for females with fecal incontinence.
authors.affiliation: Physiotherapy Service, Rabin Medical Center, Petach Tikva, Israel.
authors.forename: Nira
authors.initials: N
authors.lastname: Cohen-Zubary
authors.forename: Rachel
authors.initials: R
authors.lastname: Gingold-Belfer
authors.forename: Inna
authors.initials: I
authors.lastname: Lambort
authors.forename: Nir
authors.initials: N
authors.lastname: Wasserberg
authors.forename: Haim
authors.initials: H
authors.lastname: Krissi
authors.forename: Sigal
authors.initials: S
authors.lastname: Levy
authors.forename: Yaron
authors.initials: Y
authors.lastname: Niv
authors.forename: Ram
authors.initials: R
authors.lastname: Dickman
mesh_terms: D000368:Aged; D001007:Anxiety; D001676:Biofeedback, Psychology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004599:Electric Stimulation Therapy / Q000191:economics; D005242:Fecal Incontinence / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D017773:Pelvic Floor / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome