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A systematic review of the literature reporting on randomised controlled trials comparing treatments for faecal incontinence in adults

Authors :
Lal, Nikhil
Simillis, Constantinos
Slesser, Alistair
Kontovounisios, Christos
Rasheed, Shahnawaz
Tekkis, Paris P.
Tan, Emile
Source :
Acta Chirurgica Belgica; January 2019, Vol. 119 Issue: 1 p1-15, 15p
Publication Year :
2019

Abstract

AbstractAim:To perform a review of the literature reporting on randomised controlled trials (RCTs) comparing treatments for faecal incontinence (FI) in adults.Methods:A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify RCTs reporting on treatments for FI.Results:The review included 60 RCTs reporting on 4838 patients with a mean age ranging from 36.8 to 88 years. From the included RCTs, 32 did not identify a significant difference between the treatments compared. Contradictory results were identified in RCTs comparing percutaneous posterior tibial nerve stimulation and transcutaneous tibial nerve stimulation versus sham stimulation, biofeedback-pelvic floor muscle training (BF-PFMT) versus PFMT, and between bulking agents such as PTQTMversus Durasphere®. In two separate RCTs, combination treatment of amplitude-modulated medium frequency stimulation and electromyography-biofeedback (EMG-BF), was noted to be superior to EMG-BF and low-frequency electrical stimulation alone. Combination of non-surgical treatments such as BF with sphincteroplasty significantly improved continence scores compared to sphincteroplasty alone. Surgical treatments were associated with higher rates of serious adverse events compared to non-surgical interventions.Conclusions:The current evidence has not identified significant differences between treatments for FI, and where differences were identified, the results were contradictory between RCTs.

Details

Language :
English
ISSN :
00015458
Volume :
119
Issue :
1
Database :
Supplemental Index
Journal :
Acta Chirurgica Belgica
Publication Type :
Periodical
Accession number :
ejs48371224
Full Text :
https://doi.org/10.1080/00015458.2018.1549392