Fecal incontinence is one of the most psychological frustrating problems. It occurs in children due to many causes. There is a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation. However, up till now, there are no established guidelines for treatment. the objective of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPNS) as non-invasive methods in the treatment of functional non-retentive fecal incontinence (FNRFI) in children.
Functional non-retentive fecal incontinence (FNRFI) requires prolonged treatment with a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation (PTNS). However, up till now, there are no established guidelines for treatment.1 The aim of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPTNS) as non-invasive methods in the treatment of (FNRFI) in children. Methodology: The current prospective randomized controlled study included 93 children with FNRFI who were randomly divided and allocated into three groups. Group A treated by conventional methods through dietetic regulation and Kegal exercises. Group B treated by biofeedback therapy while group C received bilateral (TPTNS). Initial manometric findings including resting pressure, squeeze pressure, 1st sensation, 1st urge, and intense urge were recorded and repeated after 3 and 6 months together with incontinence score recorded in using St' Mark's (Varizey) with the primary endpoint of improvement of the incontinence score more than 50%.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
93
Biofeedback therapy in addition to the conventional measures done in the control Group. It was performed in the same position used for baseline manometry. The used protocol included strength and sensory training, twice weekly for 3 months. Strength training was performed by a double-lumen rectal PVC balloon clothed catheter (MMS U-72210).
A positive auto adhesive electrode was applied above the medial malleolus over the S3 dermatome. A second negative electrode was applied just below the same malleolus. Both electrodes were linked to an electrical stimulation device ( EMS physio Ltd, OX129 F, England) with a low frequency current (10 Hz), and adjustable intensity.
Conventional treatment through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation.
Banha University
Banhā, Banha, Egypt
Incontinence score using St' Mark's (Vaiszey)
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
Time frame: 3 months after intervention
incontinence score using St' Mark's (Vaiszey)
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
Time frame: 6 months after intervention
Resting pressure (mm hg)
Pressure during relaxation of the anal sphincter
Time frame: 3 months after intervention
Resting pressure (mm hg)
Pressure during relaxation of the anal sphincter
Time frame: 6 months after intervention
Squeeze pressure (mm hg)
Pressure during contraction of the anal sphincter
Time frame: 3 months after intervention
Squeeze pressure (mm hg)
Pressure during contraction of the anal sphincter
Time frame: 6 months after intervention
First sensation (volume of the balloon by cm water)
First sensation of the stool in the rectum
Time frame: 3 months after intervention
First sensation (volume of the balloon by cm water)
First sensation of the stool in the rectum
Time frame: 6 months after intervention
First Urge(volume of the balloon by cm water)
The patient is trying to hold defecation and he can
Time frame: 3 months after intervention
First Urge(volume of the balloon by cm water)
The patient is trying to hold defecation and he can
Time frame: 6 months after intervention
Intense urge (volume of the balloon by cm water)
The Patent can no longer control the defecation
Time frame: 3 months after intervention
Intense urge (volume of the balloon by cm water)
the Patent can no longer control the defecation
Time frame: 6 months after intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.