Sphincter training or anal injections of dextranomer for treatment of anal incontinence: a randomized trial

@article{Dehli2013SphincterTO,
  title={Sphincter training or anal injections of dextranomer for treatment of anal incontinence: a randomized trial},
  author={Trond Dehli and Arvid Stordahl and Lars J Vatten and P{\aa}l Richard Romundstad and Kjersti Mevik and Ylva Ingrid Sahlin and Rolv-Ole Lindsetmo and Barthold Vonen},
  journal={Scandinavian Journal of Gastroenterology},
  year={2013},
  volume={48},
  pages={302 - 310}
}
Abstract Objective. The objective is to test if the injection of a bulking agent in the anal canal is superior to sphincter training with biofeedback in the treatment of anal incontinence. Background. Anal incontinence is traditionally treated with conservative measures, such as pads and constipating medicine. If this fails, sphincter training with biofeedback is often offered before more advanced surgical procedures are considered. The injection of a bulking agent in the anal canal is a… Expand
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References

SHOWING 1-10 OF 29 REFERENCES
[Anal incontinence--assessment of a new treatment].
TLDR
A pilot-study with a new bulking agent (hyaluronic acid and dextranomere) and a new injection technique for anal incontinence was well tolerated, easy to perform within an outpatient setting and with promising short-term results. Expand
Efficacy of dextranomer in stabilised hyaluronic acid for treatment of faecal incontinence: a randomised, sham-controlled trial
TLDR
Anal injection of NASHA Dx is an effective treatment for faecal incontinence and a refinement of selection criteria for patients, optimum injected dose, ideal site of injection, and long-term results might further increase the acceptance of this minimally invasive treatment. Expand
Injectable Silicone Biomaterial for Fecal Incontinence Caused by Internal Anal Sphincter Dysfunction Is Effective
TLDR
Injection of silicone biomaterial provided a marked improvement in fecal continence and quality of life in patients with internal sphincter dysfunction, despite the presence of pudendal neuropathy. Expand
Perianal injectable bulking agents as treatment for faecal incontinence in adults.
TLDR
One large randomised controlled trial has shown that this form of treatment using dextranomer in stabilised hyaluronic acid (NASHA Dx) improves continence for a little over half of patients in the short term, however, the number of identified trials was limited and most had methodological weaknesses. Expand
Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults.
TLDR
There is some evidence that biofeedback and electrical stimulation may enhance the outcome of treatment compared to electrical stimulation alone or exercises alone, but exercises appear to be less effective than an implanted sacral nerve stimulator. Expand
Randomized controlled trial of biofeedback for fecal incontinence.
TLDR
Conservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function and benefit is maintained in the medium term. Expand
Functional changes after physiotherapy in fecal incontinence
TLDR
Physiotherapy improves squeeze pressure, urge sensation, and maximum tolerable volume, however, improved anorectal function does not always result in a decrease in fecal incontinence complaints. Expand
Randomized Controlled Trial Shows Biofeedback to be Superior to Pelvic Floor Exercises for Fecal Incontinence
TLDR
Biofeedback was also more effective than pelvic floor exercises alone in producing adequate relief of fecal incontinence symptoms in patients for whom conservative medical management had failed. Expand
Triple Target Treatment (3T) Is More Effective Than Biofeedback Alone for Anal Incontinence: The 3T-AI Study
TLDR
The combination of amplitude-modulated medium-frequency electrostimulation with EMG-biofeedback in the triple target regimen is superior to EMG -bio feedback alone in the treatment of anal incontinence. Expand
Operant conditioning of rectosphincteric responses in the treatment of fecal incontinence.
TLDR
The findings highlight the importance of synchronized rectosphincteric responses in the maintenance of fecal continence and show that these responses can be brought under voluntary control in patients with chronic fecal incontinence, even when theincontinence is secondary to organic lesions. Expand
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