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Faecal incontinence

D Roorda, M J Witvliet, L M Wellens, D V Schulten, C E J Sloots, I de Blaauw, P M A Broens, J Oosterlaan, L W E van Heurn, A F W van der Steeg
AIM: Total colonic aganglionosis (TCA) is a severe form of Hirschsprung's Disease (HD) associated with a high morbidity. This study assesses long-term functional outcome and Quality of Life (QoL) of TCA patients in a national consecutive cohort. METHODS: Medical records of all patients (n=53) diagnosed between 1995 and 2015 were reviewed on surgical and demographic characteristics. Functional outcome of all non-syndromal patients, aged ≥ four years (n=35) was assessed in medical records and with a questionnaire...
March 15, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
P F Vollebregt, A A van Bodegraven, T M L Markus-de Kwaadsteniet, D van der Horst, R J F Felt-Bersma
BACKGROUND: Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described. AIMS: To determine the impacts of perianal disease and faecal incontinence on quality of life and employment in inflammatory bowel disease patients. METHODS: For this cross-sectional study, a comprehensive survey was sent out to members of the Dutch National Crohn's and Colitis patient organisation...
March 9, 2018: Alimentary Pharmacology & Therapeutics
Xiaojia Li, Xiutian Guo, Weiqi Jin, Jingen Lu
BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) and acupuncture are known to mitigate tissue damage. This study aimed to investigate the therapeutic effects of combined electroacupuncture (EA) stimulation and BMSC injection in a rat model of anal sphincter injury-induced faecal incontinence (FI). METHODS: 60 Sprague-Dawley rats were randomly divided into five groups: sham-operated control, FI, FI+EA, FI+BMSC, and FI+BMSC+EA. The anorectal tissues were collected on days 1, 3, 7 and 14...
March 8, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
Stefan H E M Clermonts, Yu-Ting van Loon, Dareczka K Wasowicz, Barbara S Langenhoff, David D E Zimmerman
BACKGROUND: Transanal minimally invasive surgery (TAMIS) is considered the successor of transanal endoscopic microsurgery (TEMS). It makes use of more readily available laparoscopic instruments and single-port access platforms with similar perioperative, clinical and oncological outcomes. Little is known about quality of life (QoL) outcomes after the use of TAMIS. The aim of this study was to assess QoL after TAMIS in our patients and compare this with QoL in the healthy Dutch population...
March 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Constantinos Simillis, Nikhil Lal, Shengyang Qiu, Christos Kontovounisios, Shahnawaz Rasheed, Emile Tan, Paris P Tekkis
AIMS: Percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) are both second-line treatments for faecal incontinence (FI). To compare the clinical outcomes and effectiveness of SNS versus PTNS for treating FI in adults. METHOD: A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify studies comparing SNS and PTNS for treating FI. A risk of bias assessment was performed using The Cochrane Collaboration's risk of bias tool...
February 22, 2018: International Journal of Colorectal Disease
Kapil Sahnan, Phil J Tozer, Samuel O Adegbola, Matthew J Lee, Nick Heywood, Angus G K McNair, Daniel Hind, Nuha Yassin, Alan J Lobo, Steven R Brown, Shaji Sebastian, Robin K S Phillips, Phillip F C Lung, Omar D Faiz, Kay Crook, Sue Blackwell, Azmina Verjee, Ailsa L Hart, Nicola S Fearnhead
OBJECTIVE: Lack of standardised outcomes hampers effective analysis and comparison of data when comparing treatments in fistulising perianal Crohn's disease (pCD). Development of a standardised set of outcomes would resolve these issues. This study provides the definitive core outcome set (COS) for fistulising pCD. DESIGN: Candidate outcomes were generated through a systematic review and patient interviews. Consensus was established via a three-round Delphi process using a 9-point Likert scale based on how important they felt it was in determining treatment success culminating in a final consensus meeting...
February 3, 2018: Gut
John Guinane, Rosie Crone
BACKGROUND: Faecal incontinence significantly affects a patient's quality of life, and limited research has been conducted into effective interventions that are specific to residential aged care. Australian and New Zealand prevalence data indicate a general faecal incontinence rate of 12-13% in older adults and up to 50% in residential aged care. OBJECTIVE: The objective of this article is to describe the suggested initial investigation and management of faecal incontinence in older adults residing in residential aged care...
January 2018: Aust J Gen Pract
William E Stokes, David G Jayne, Ali Alazmani, Peter R Culmer
This article presents a method to fabricate, measure and control a physical simulation of the human defecatory system to investigate individual and combined effects of anorectal angle and sphincter pressure on continence. To illustrate the capabilities and clinical relevance of the work, the influence of a passive-assistive artificial anal sphincter (FENIXTM) is evaluated. A model rectum and associated soft tissues, based on geometry from an anonymised computed tomography dataset, was fabricated from silicone and showed behavioural realism to the biological system and ex vivo tissue...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Debbie L Shawcross
Overt and covert hepatic encephalopathy (HE) are debilitating complications of cirrhosis. HE results in a poor quality of life for patients and their caregivers and, unless there is access to liver transplantation, the prognosis is poor. The development of overt HE is often unpredictable, and its management, particularly in the ward, remains challenging. There is an urgent need for novel approaches to treat HE. Until recently, therapies for this complication were disappointing, with frequently intolerable side effects such as diarrhoea and faecal incontinence...
February 7, 2018: British Journal of Nursing: BJN
Patrina Caldwell, Karen Scott, Marianne Kerr, Deborah O'Mara
BACKGROUND: Paediatric incontinence has traditionally been managed through a discipline-specific approach by doctors, nurses, physiotherapists and psychologists. We evaluated a workshop aiming to increase health professionals' knowledge, confidence and willingness to involve other health professionals when managing paediatric incontinence. METHODS: Our 1-day workshop focused on paediatric bedwetting, daytime incontinence, faecal incontinence and neurogenic bladder...
January 25, 2018: Clinical Teacher
Vikash Kumar, Chirag Punatar, Kunal Jadhav, Sharad Sagade
Prostatic utricle cyst is a rare congenital anomaly. Symptomatic cysts require treatment. Surgical excision is the treatment of choice, but is challenging due to close proximity to vas deferens, ejaculatory ducts, bladder, prostate, rectum and pelvic nerves. Complications include rectal injury, ureteral injury, impotence, infertility and faecal incontinence. We here report a rare complication in which bladder was accidentally removed during laparoscopic excision of prostatic utricle cyst. To best of our knowledge such a complication has never been reported previously...
January 26, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
L Lagares-Tena, L Millán-Paredes, L Lázaro-García, A Navarro-Luna, S Delgado-Rivilla, A Muñoz-Duyos
BACKGROUND: The aim of the present study was to evaluate the effectiveness of sacral neuromodulation (SNM) as a treatment for congenital faecal incontinence (FI). METHODS: A retrospective study was conducted on patients with congenital FI who had SNM surgery at our institution between October 2005 and June 2013. An initial percutaneous nerve evaluation was performed, and patients with an improvement of more than 50% in their symptoms had permanently implants for SNM treatment...
January 16, 2018: Techniques in Coloproctology
E Falletto, S Brown, G Gagliardi
No abstract text is available yet for this article.
January 8, 2018: Techniques in Coloproctology
A C Roslani, R Ramakrishnan, S Azmi
BACKGROUND: Faecal incontinence (FI) is not a common presenting complaint in Malaysia, and little has been published on this topic. Since it is a treatable condition, a greater understanding of factors contributing to healthseeking behaviour is needed in order to plan effective provision of services. METHODS: A survey of 1000 patients and accompanying relatives, visiting general surgical and obstetrics and gynaecology clinics for matters unrelated to FI, was conducted at University Malaya Medical Centre between January 2009 and February 2010...
December 2017: Medical Journal of Malaysia
Hilde Beele, Steven Smet, Nele Van Damme, Dimitri Beeckman
Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region...
January 2018: Drugs & Aging
Sue Woodward
No abstract text is available yet for this article.
December 14, 2017: British Journal of Nursing: BJN
K L White, E Varrassi, J A Routledge, L H Barraclough, J E Livsey, J McLaughlin, S E Davidson
AIMS: Growing numbers of patients with cancer are surviving after treatment with pelvic radiotherapy. We evaluated the technique of volumetric modulated arc therapy (VMAT), which delivers a decreased dose to the organs at risk. We aimed to determine outcomes of this technique in terms of patient-reported acute toxicity and late effects and correlate the frequency of gastrointestinal symptoms with the volume of bowel receiving radiation dose. MATERIALS AND METHODS: Patients who were to receive VMAT for gynaecological malignancy completed patient-reported outcomes at baseline, the end of treatment, 8 weeks and 1 year...
November 9, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
Debra Bick, Annette Briley, Peter Brocklehurst, Pollyanna Hardy, Edmund Juszczak, Lynn Lynch, Christine MacArthur, Phillip Moore, Mary Nolan, Oliver Rivero-Arias, Julia Sanders, Andrew Shennan, Matt Wilson
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an 'upright position' throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a 'lying-down' position? DESIGN: Two-arm randomised controlled trial...
November 2017: Health Technology Assessment: HTA
Lesley Dibley, Christine Norton, Elizabeth Whitehead
AIM: To explore experiences of stigma in people with inflammatory bowel disease. BACKGROUND: Diarrhoea, urgency and incontinence are common symptoms in inflammatory bowel disease. Social rules stipulate full control of bodily functions in adulthood: poor control may lead to stigmatization, affecting patients' adjustment to disease. Disease-related stigma is associated with poorer clinical outcomes, but qualitative evidence is minimal. DESIGN: An interpretive (hermeneutic) phenomenological study of the lived experience of stigma in inflammatory bowel disease...
November 3, 2017: Journal of Advanced Nursing
Hoey Koh, Stephen McSorley, Sarah Hunt, Martha Quinn, Graham MacKay, John Anderson
INTRODUCTION: Sacral nerve stimulation (SNS) is increasingly popular in the management of faecal incontinence. This paper reports the first 10-year experience of SNS in the management of faecal incontinence at a tertiary referral centre. Data was collected in a prospectively maintained database. RESULTS: In total 130 patients were referred. The majority were women (94%) under 75-year-old (98%). Seven patients were found to have full-thickness rectal prolapse at the initial work-up and proceeded to rectopexy...
October 25, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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