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  1. Article ; Online: Investigation and treatment of faecal incontinence.

    Maslekar, S / Gardiner, A / Maklin, C / Duthie, G S

    Postgraduate medical journal

    2006  Volume 82, Issue 968, Page(s) 363–371

    Abstract: Faecal incontinence is a debilitating condition affecting people of all ages, and significantly ... to establish the severity and type of incontinence. Several treatment options with promising results exist ... incontinence or those resistant to initial treatment should be evaluated by anorectal physiology testing ...

    Abstract Faecal incontinence is a debilitating condition affecting people of all ages, and significantly impairs quality of life. Proper clinical assessment followed by conservative medical therapy leads to improvement in more than 50% of cases, including patients with severe symptoms. Patients with advanced incontinence or those resistant to initial treatment should be evaluated by anorectal physiology testing to establish the severity and type of incontinence. Several treatment options with promising results exist. Patients with gross sphincter defects should undergo surgical repair. Those who fail to respond to sphincteroplasty and those with no anatomical defects have the option of either sacral nerve stimulation or other advanced procedures. Stoma formation should be reserved for patients who do not respond to any of the above procedures.
    MeSH term(s) Artificial Organs ; Fecal Incontinence/diagnosis ; Fecal Incontinence/etiology ; Fecal Incontinence/therapy ; Humans ; Medical History Taking/methods ; Physical Examination/methods ; Surgical Flaps ; Transcutaneous Electric Nerve Stimulation/methods
    Language English
    Publishing date 2006-05-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80325-x
    ISSN 1469-0756 ; 0032-5473
    ISSN (online) 1469-0756
    ISSN 0032-5473
    DOI 10.1136/pgmj.2005.044099
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  2. Article: Faecal incontinence: investigation, treatment and management.

    Nazarko, Linda

    British journal of community nursing

    2018  Volume 23, Issue 12, Page(s) 582–588

    Abstract: Faecal incontinence (FI) is a hidden problem that is under-diagnosed, under-investigated and under ... the importance of assessment, what treatments are available and how intractable FI can best be managed. ... treated. Up to 10% of adults can experience an episode of FI. The prevalence of FI in the adult population ...

    Abstract Faecal incontinence (FI) is a hidden problem that is under-diagnosed, under-investigated and under treated. Up to 10% of adults can experience an episode of FI. The prevalence of FI in the adult population has been estimated at 0.8-6.2%. Recent North American research indicates a prevalence of 8.3% in adults living in the community. This article explores the reasons why adults can develop FI, the importance of assessment, what treatments are available and how intractable FI can best be managed.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Chronic Disease/therapy ; Curriculum ; Disease Management ; Education, Medical, Continuing ; Fecal Incontinence/diagnosis ; Fecal Incontinence/therapy ; Female ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2018-12-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2146386-4
    ISSN 1462-4753
    ISSN 1462-4753
    DOI 10.12968/bjcn.2018.23.12.582
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  3. Article: [Feasibility investigation of three cavity clearance in treatment of perianal abscess].

    Chen, Yan / Wang, Xiaofeng / Jin, Heiying / Zhang, Bei / Yao, Hang / Wu, Kunlan / Wang, Shuiming

    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery

    2016  Volume 19, Issue 4, Page(s) 442–445

    Abstract: ... Three-cavity clearance is feasible in treatment of perianal abscess, and can decrease the rate ... 12.0%(3/25) in seton group (all P<0.01). There was no patient with faecal incontinence in TCC group ... fecal incontinence(Wexner score) and wound healing were compared among groups.: Results: One week after operation ...

    Abstract Objective: To explore the feasibility of three-cavity clearance (TCC) in the treatment of perianal abscess.
    Methods: A retrospective study of patients with perianal abscess in our center from July 2013 to March 2015 were carried out. Clinical data of 25 patients undergoing TCC (TCC group) were analyzed. At the same time, based on matched gender, age and location of abscess, 25 patients undergoing incision and drainage (incision group) and 25 undergoing cutting seton (seton group) were enrolled. Postoperative pain visual analogue scale (VAS) score (the first defecation,1 week later), rate of fistula formation, fecal incontinence(Wexner score) and wound healing were compared among groups.
    Results: One week after operation, VAS score in seton group was 6.5±1.3, which was significantly higher than 1.3±0.5 in TCC group and 1.2±0.4 in incision group(P<0.01), while there were no significant differences of VAS among groups at the first defecation(P>0.05). Time of wound healing was (45.8±19.9), (49.2±23.1) and (53.5±24.1) days in TCC, incision and seton group respectively, without significant difference(P>0.05). Rate of fistula formation was 48.0% (12/25) in incision group, which was significantly higher than 12.0% (3/25) in TCC group and 12.0%(3/25) in seton group (all P<0.01). There was no patient with faecal incontinence in TCC group and incision group, while 2 patients with fecal incontinence were found in seton group.
    Conclusion: Three-cavity clearance is feasible in treatment of perianal abscess, and can decrease the rate of fistula formation, ameliorate postoperative pain and protect anal function.
    MeSH term(s) Abscess/surgery ; Anus Diseases/surgery ; Defecation ; Digestive System Surgical Procedures/methods ; Drainage ; Fecal Incontinence ; Humans ; Postoperative Period ; Retrospective Studies ; Wound Healing
    Language Chinese
    Publishing date 2016-04
    Publishing country China
    Document type Comparative Study ; English Abstract ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1671-0274
    ISSN 1671-0274
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  4. Article ; Online: SaFaRI: sacral nerve stimulation versus the FENIX magnetic sphincter augmentation for adult faecal incontinence: a randomised investigation.

    Williams, Annabelle E / Croft, Julie / Napp, Vicky / Corrigan, Neil / Brown, Julia M / Hulme, Claire / Brown, Steven R / Lodge, Jen / Protheroe, David / Jayne, David G

    International journal of colorectal disease

    2016  Volume 31, Issue 2, Page(s) 465–472

    Abstract: ... in the treatment of faecal incontinence, will recruit 350 patients randomised equally to receive either SNS or ... Purpose: Faecal incontinence is a physically, psychologically and socially disabling condition ... a new technology for faecal incontinence, the FENIX™ MSA, allowing its safe and controlled introduction ...

    Abstract Purpose: Faecal incontinence is a physically, psychologically and socially disabling condition. NICE guidance (2007) recommends surgical intervention, including sacral nerve stimulation (SNS), after failed conservative therapies. The FENIX magnetic sphincter augmentation (MSA) device is a novel continence device consisting of a flexible band of interlinked titanium beads with magnetic cores that is placed around the anal canal to augment anal sphincter tone through passive attraction of the beads. Preliminary studies suggest the FENIX MSA is safe, but efficacy data is limited. Rigorous evaluation is required prior to widespread adoption.
    Method and design: The SaFaRI trial is a National Institute of Health Research (NIHR) Health Technology Assessment (HTA)-funded UK multi-site, parallel group, randomised controlled, unblinded trial that will investigate the use of the FENIX MSA, as compared to SNS, for adult faecal incontinence resistant to conservative management. Twenty sites across the UK, experienced in the treatment of faecal incontinence, will recruit 350 patients randomised equally to receive either SNS or FENIX MSA. Participants will be followed-up at 2 weeks post-surgery and at 6, 12 and 18 months post-randomisation. The primary endpoint is success, as defined by device in use and ≥50 % improvement in the Cleveland Clinic Incontinence Score (CCIS) at 18 months post-randomisation. Secondary endpoints include complications, quality of life and cost effectiveness.
    Discussion: SaFaRI will rigorously evaluate a new technology for faecal incontinence, the FENIX™ MSA, allowing its safe and controlled introduction into current clinical practice. These results will inform the future surgical management of adult faecal incontinence.
    MeSH term(s) Adult ; Anal Canal ; Cost-Benefit Analysis ; Electric Stimulation Therapy/adverse effects ; Electric Stimulation Therapy/economics ; Electric Stimulation Therapy/methods ; Fecal Incontinence/therapy ; Humans ; Magnetic Field Therapy/adverse effects ; Magnetic Field Therapy/economics ; Magnetic Field Therapy/methods ; Prospective Studies ; Quality of Life ; Sacrum/innervation ; Spinal Nerves
    Language English
    Publishing date 2016-01-12
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-015-2492-3
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  5. Article ; Online: Sacral nerve stimulation for faecal incontinence: response rate, satisfaction and the value of preoperative investigation in patient selection.

    Vallet, C / Parc, Y / Lupinacci, R / Shields, C / Parc, R / Tiret, E

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2010  Volume 12, Issue 3, Page(s) 247–253

    Abstract: Objective: Before undergoing sacral nerve stimulation (SNS) for faecal incontinence (FI), patients ... are investigated with morphologic, dynamic and electrophysiologic tests. The purpose of our study was ... Patients were reviewed at 3 months and then at 6 monthly intervals. Asked by telephone, patient's ...

    Abstract Objective: Before undergoing sacral nerve stimulation (SNS) for faecal incontinence (FI), patients are investigated with morphologic, dynamic and electrophysiologic tests. The purpose of our study was to evaluate their value in the selection of patients who may benefit most from neuromodulation.
    Method: If temporary stimulation resulted in a good objective response, a permanent neuromodulator was implanted. Patients were reviewed at 3 months and then at 6 monthly intervals. Asked by telephone, patient's satisfaction was described as good, satisfactory or poor.
    Results: Forty-five consecutive patients (41 females, median age 59 years) with FI (Wexner 16.1 +/- 2.9) underwent SNS. Temporary stimulation was successful in 32 (71)% patients. At a median follow-up of 33 months, the neuromodulator remained in place in 25 (55%) patients, two do whom switched it off, leaving 23 (51%) with a functioning neuromodulator. There was no statistically significant difference between the characteristics (including manometry, ultrasound and electrophysiology) of patients undergoing implantation (n = 32) or not (n = 13) and those with or without a functioning stimulator (n = 23: n = 13). In the 23 patients with a functioning stimulator the result was good in 12, satisfactory in five and poor in six. There was no statistically significant difference in the patient characteristics between those with a good result (n = 12) and the remainder (n = 32).
    Conclusion: The findings suggest that investigation for FI does not facilitate patient selection for SNS and cannot be used to predict outcome.
    MeSH term(s) Aged ; Anal Canal/innervation ; Electric Stimulation Therapy/methods ; Electrodes, Implanted ; Fecal Incontinence/therapy ; Female ; Follow-Up Studies ; Humans ; Lumbosacral Plexus ; Male ; Middle Aged ; Patient Satisfaction ; Patient Selection ; Rectum/innervation ; Treatment Failure
    Language English
    Publishing date 2010-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/j.1463-1318.2009.01899.x
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  6. Article ; Online: Investigation of the distribution and function of alpha-adrenoceptors in the sheep isolated internal anal sphincter.

    Rayment, S J / Eames, T / Simpson, J A D / Dashwood, M R / Henry, Y / Gruss, H / Acheson, A G / Scholefield, J H / Wilson, V G

    British journal of pharmacology

    2010  Volume 160, Issue 7, Page(s) 1727–1740

    Abstract: ... derivatives for potential treatment of faecal incontinence.: Experimental approach: Saturation and ... by various imidazoline derivatives. These agents may prove useful in the treatment of faecal incontinence. ... Background and purpose: We have investigated the distribution of alpha-adrenoceptors in sheep ...

    Abstract Background and purpose: We have investigated the distribution of alpha-adrenoceptors in sheep internal anal sphincter (IAS), as a model for the human tissue, and evaluated various imidazoline derivatives for potential treatment of faecal incontinence.
    Experimental approach: Saturation and competition binding with (3)H-prazosin and (3)H-RX821002 were used to confirm the presence and density of alpha-adrenoceptors in sheep IAS, and the affinity of imidazoline compounds at these receptors. A combination of in vitro receptor autoradiography and immunohistochemistry was used to investigate the regional distribution of binding sites. Contractile activity of imidazoline-based compounds on sheep IAS was assessed by isometric tension recording.
    Key results: Saturation binding confirmed the presence of both alpha(1)- and alpha(2)-adrenoceptors, and subsequent characterization with sub-type-selective agents, identified them as alpha(1A)- and alpha(2D)-adrenoceptor sub-types. Autoradiographic studies with (3)H-prazosin showed a positive association of alpha(1)-adrenoceptors with immunohistochemically identified smooth muscle fibres. Anti-alpha(1)-adrenoceptor immunohistochemistry revealed similar distributions of the receptor in sheep and human IAS. The imidazoline compounds caused concentration-dependent contractions of the anal sphincter, but the maximum responses were less than those elicited by l-erythro-methoxamine, a standard non-imidazoline alpha(1)-adrenoceptor agonist. Prazosin (selective alpha(1)-adrenoceptor antagonist) significantly reduced the magnitude of contraction to l-erythro-methoxamine at the highest concentration used. Both prazosin and RX811059 (a selective alpha(2)-adrenoceptor antagonist) reduced the potency (pEC(50)) of clonidine.
    Conclusions and implications: This study shows that both alpha(1)- and alpha(2)-adrenoceptors are expressed in the sheep IAS, and contribute (perhaps synergistically) to contractions elicited by various imidazoline derivatives. These agents may prove useful in the treatment of faecal incontinence.
    MeSH term(s) Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-2 Receptor Antagonists ; Adrenergic alpha-Agonists/pharmacology ; Adrenergic alpha-Antagonists/pharmacology ; Anal Canal/drug effects ; Anal Canal/metabolism ; Animals ; Antibodies, Monoclonal/pharmacology ; Autoradiography ; Binding, Competitive ; Dose-Response Relationship, Drug ; Fecal Incontinence/metabolism ; Humans ; Idazoxan/analogs & derivatives ; Idazoxan/pharmacology ; Immunohistochemistry ; In Vitro Techniques ; Muscle Contraction/drug effects ; Prazosin/pharmacology ; Protein Binding ; Radioligand Assay ; Receptors, Adrenergic, alpha-1/biosynthesis ; Receptors, Adrenergic, alpha-1/metabolism ; Receptors, Adrenergic, alpha-2/biosynthesis ; Receptors, Adrenergic, alpha-2/metabolism ; Sheep/metabolism
    Chemical Substances Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-2 Receptor Antagonists ; Adrenergic alpha-Agonists ; Adrenergic alpha-Antagonists ; Antibodies, Monoclonal ; Receptors, Adrenergic, alpha-1 ; Receptors, Adrenergic, alpha-2 ; 2-methoxyidazoxan (E27LB7P0ET) ; Prazosin (XM03YJ541D) ; Idazoxan (Y310PA316B)
    Language English
    Publishing date 2010-10-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 80081-8
    ISSN 1476-5381 ; 0007-1188
    ISSN (online) 1476-5381
    ISSN 0007-1188
    DOI 10.1111/j.1476-5381.2010.00842.x
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  7. Article ; Online: Libertas: rationale and study design of a multicentre, Phase II, double-blind, randomised, placebo-controlled investigation to evaluate the efficacy, safety and tolerability of locally applied NRL001 in patients with faecal incontinence.

    Siproudhis, L / Jones, D / Shing, R Ng Kwet / Walker, D / Scholefield, J H

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2014  Volume 16 Suppl 1, Page(s) 59–66

    Abstract: ... controlled clinical trials of treatment for faecal incontinence and little clinical evidence is available to inform the most ... Aims: Faecal incontinence affects up to 8% of adults. Associated social isolation and subsequent ... and 8 weeks assessed by the Vaizey score; and QoL using the Faecal Incontinence Quality of Life and ...

    Abstract Aims: Faecal incontinence affects up to 8% of adults. Associated social isolation and subsequent depression can have devastating effects on quality of life (QoL). Faecal incontinence is an underreported health problem as the social isolation and stigma that patients experience makes it difficult for sufferers to discuss their condition with a physician. There have been few well-designed, placebo-controlled clinical trials of treatment for faecal incontinence and little clinical evidence is available to inform the most appropriate management strategies. Libertas, a robustly designed study will investigate the efficacy and safety of NRL001 (1R,2S-methoxamine), an α1 -adrenoceptor agonist, in the treatment of faecal incontinence.
    Methods: Libertas is a multicentre, Phase II, double-blind, randomised, placebo-controlled, parallel group study. Patient recruitment took place across 55 study centres in Europe. Patients suffering with faecal incontinence were randomised into four groups (approximately 110 each) to receive once daily self-administered doses of NRL001 (5, 7.5 or 10 mg or placebo in a suppository formulation) for 8 weeks. The primary objective of Libertas is to assess the impact of once daily administration of NRL001 on the severity and frequency of incontinence episodes as assessed by the Wexner score at 4 weeks, compared with placebo. Secondary outcomes include measures of efficacy of NRL001 compared with placebo following 8 weeks treatment; safety and tolerability; evaluation of plasma pharmacokinetics; establishment of any pharmacokinetic/pharmacodynamic relationship to adverse events; dose-response relationship; the efficacy of NRL001 therapy at 4 and 8 weeks assessed by the Vaizey score; and QoL using the Faecal Incontinence Quality of Life and the EQ-5D-5L Healthcare Questionnaires following 4 and 8 weeks NRL001 therapy. Overall patient satisfaction with the treatment will also be evaluated.
    Discussion: This is the first randomised controlled study to investigate the efficacy and safety of a selective α1 -adrenoceptor agonist for the treatment of faecal incontinence. Furthermore, this is the first time the impact of NRL001 on assessments of QoL, health outcomes and patient satisfaction will be assessed. Innovative strategies were developed to meet the challenge of recruiting patients for this study, for example, media advertising, posters and mailshots as allowed by each study centre.
    MeSH term(s) Adrenergic alpha-1 Receptor Agonists/administration & dosage ; Adrenergic alpha-1 Receptor Agonists/adverse effects ; Adrenergic alpha-1 Receptor Agonists/pharmacokinetics ; Adrenergic alpha-1 Receptor Agonists/therapeutic use ; Double-Blind Method ; Drug Tolerance ; Fecal Incontinence/drug therapy ; Methoxamine/adverse effects ; Methoxamine/pharmacokinetics ; Methoxamine/therapeutic use ; Patient Satisfaction ; Stereoisomerism ; Suppositories ; Treatment Outcome
    Chemical Substances Adrenergic alpha-1 Receptor Agonists ; Suppositories ; Methoxamine (HUQ1KC1YLI)
    Language English
    Publishing date 2014-03
    Publishing country England
    Document type Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.12546
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  8. Article: A study of female urinary tract infection caused by urodynamic investigation.

    Yip, Shing-Kai / Fung, Kitty / Pang, Man-Wah / Leung, Peter / Chan, Daniel / Sahota, Daljit

    American journal of obstetrics and gynecology

    2004  Volume 190, Issue 5, Page(s) 1234–1240

    Abstract: ... the urodynamic investigation were Escherichia coli (46.3%), Enterococcus spp (16.4%), and Enterococcus faecalis ... 11.9%).: Conclusion: Despite a stringent screen-and-treat protocol before urodynamic investigation ... urinary tract infection before and after urodynamic investigation and to identify the risk factors ...

    Abstract Objective: The purpose of this study was to assess the prevalence of female urinary tract infection before and after urodynamic investigation and to identify the risk factors for urinary tract infection after urodynamic investigation.
    Study design: Eight hundred twenty-two consecutive incontinent women were recruited. All women were "double-screened" and treated for urinary tract infection before urodynamic investigation: first by mid stream urine culture 4 to 6 weeks before investigation and then by reagent strips for urine leukocytes and nitrites at the time of investigation. The investigation was postponed until the urinary tract infection had been treated. All women then received a standard urodynamic investigation.
    Results: The prevalence of urinary tract infection before urodynamic investigation was 5.1% (95% CI, 3.6-6.6), and the prevalence after the investigation was 8.4% (95% CI, 6.5-10.3). Three independent risk factors were identified: age >or=70 years (odds ratio, 1.99; 95% CI, 1.14-3.48), previous continence surgery (odds ratio, 1.90; 95% CI, 1.05-3.43), and urinary tract infection before urodynamic investigation (odds ratio, 3.13; 95% CI, 1.43-6.83). The 3 most common uropathogens in the urinary tract infections after the urodynamic investigation were Escherichia coli (46.3%), Enterococcus spp (16.4%), and Enterococcus faecalis (11.9%).
    Conclusion: Despite a stringent screen-and-treat protocol before urodynamic investigation, patients still experienced urinary tract infection.
    MeSH term(s) Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Humans ; Logistic Models ; Middle Aged ; Prevalence ; Probability ; Prognosis ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Urinalysis ; Urinary Catheterization ; Urinary Incontinence/diagnosis ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/etiology ; Urodynamics
    Language English
    Publishing date 2004-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2003.12.028
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  9. Article: A regional audit of the investigation and treatment of colorectal and pelvic floor disorders (1984-1991).

    Varma, J S / Binnie, N R / Kawimbe, B / Papachrysostomou, M / Smith, A N

    International journal of colorectal disease

    1993  Volume 8, Issue 2, Page(s) 66–70

    Abstract: ... increasing use of non-surgical therapeutic modalities for the treatment of faecal incontinence and ... its evolution described over a period of eight years. Trends in surgical treatment of some of these disorders ... The activities of a regional physiology unit established for the investigation of colorectal and ...

    Abstract The activities of a regional physiology unit established for the investigation of colorectal and pelvic floor physiology in health and disease in a clinically relevant setting has been audited and its evolution described over a period of eight years. Trends in surgical treatment of some of these disorders over the same period have also been documented in the Lothian Region. Although there has been little change in the number of patients investigated annually patterns of investigation appear to change. Sphincter manometry, proctometrography and somatosensory reflex measurements have remained the most frequently performed and useful investigations. Spinal stimulation studies increased transiently because of a collaborative investigation of bowel and bladder function in patients with spinal injuries. A considerable increase in surface EMG tests and dynamic proctography has occurred. These trends are thought to be related to interest in defining evacuation dysfunction of the rectum and related problems of the pelvic floor. Isotope proctography now rivals barium videoproctography; at the same time the use of manometric colonic motility studies has diminished. Anal ultrasonography has replaced sphincter mapping in the last year and is being applied to other aspects of anorectal pathology. The last 4 years have seen the introduction and increasing use of non-surgical therapeutic modalities for the treatment of faecal incontinence and constipation: reflex electronic sphincter stimulation, biofeedback and the use of a prokinetic agent to promote colonic motility. Concomitant changes in the surgery of constipation and reconstructive anorectal procedures have been observed. It is recommended that coloproctology units should have easy access to at least one such investigation laboratory within their catchment area together with appropriate auditing facilities.
    MeSH term(s) Colonic Diseases/diagnosis ; Colonic Diseases/therapy ; Colorectal Surgery/statistics & numerical data ; Female ; Hospitals, General/statistics & numerical data ; Humans ; Laboratories, Hospital/statistics & numerical data ; Male ; Medical Audit/statistics & numerical data ; Pelvic Floor ; Rectal Diseases/diagnosis ; Rectal Diseases/therapy ; Scotland
    Language English
    Publishing date 1993-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/bf00299329
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