Faecal incontinence is a common and disturbing condition, which leads to impaired quality of life and huge social and economic costs. Although recent studies have identified novel diagnostic modalities and therapeutic options, the best diagnostic and therapeutic approach is not yet completely known and shared among experts in this field. The Italian Society of Colorectal Surgery and the Italian Association of Hospital Gastroenterologists selected a pool of experts to constitute a joint committee on the basis of their experience in treating pelvic floor disorders. The aim was to develop a position paper on the diagnostic and therapeutic aspects of faecal incontinence, to provide practical recommendations for a cost-effective diagnostic work-up and a tailored treatment strategy. The recommendations were defined and graded on the basis of levels of evidence in accordance with the criteria of the Oxford Centre for Evidence-Based Medicine, and were based on currently published scientific evidence. Each statement was drafted through constant communication and evaluation conducted both online and during face-to-face working meetings. A brief recommendation at the end of each paragraph allows clinicians to find concise responses to each diagnostic and therapeutic issue.
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http://dx.doi.org/10.1016/j.dld.2015.03.028 | DOI Listing |
Stem Cell Res Ther
December 2024
National Colorectal Disease CenterNanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210022, Jiangsu, People's Republic of China.
Background: Complex perianal fistulas, challenging to treat and prone to recurrence, often require surgical intervention that may cause fecal incontinence and lower quality of life due to large surgical wounds and potential sphincter damage. Human umbilical cord-derived MSCs (hUC-MSCs) and their exosomes (hUCMSCs-Exo) may promote wound healing.
Methods: This study assessed the efficacy, mechanisms, and safety of these exosomes in treating complex perianal fistulas in SD rats.
BMJ Open
December 2024
School of Health Sciences, University of Southampton, Southampton, Hampshire, UK.
Introduction: Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence-associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidence-based clinical algorithm and an e-learning training programme for the prevention and treatment of IAD.
View Article and Find Full Text PDFJ Electromyogr Kinesiol
December 2024
Department of Obstetrical and Gynecological Pathology, Division of General Surgery and Medical Surgical Specialities, University of Catania, Catania, Italy. Electronic address:
Objective: To investigate the impact of mediolateral episiotomy on the innervation zones of the External Anal Sphincter (EAS) in the absence and presence of direct muscular injury.
Methods: This case series examined four primiparous women, including three who underwent vaginal deliveries with mediolateral episiotomy and one cesarean section case for reference. Pre- and post-delivery assessments utilized surface electromyography (sEMG) and endoanal ultrasound to evaluate changes in the EAS's innervation zones and obstetrical EAS injuries, alongside the Wexner score for fecal incontinence.
Cureus
November 2024
Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT.
This literature review explores the role of biofeedback therapy (BFT) in managing functional fecal incontinence (FFI) in children - a common condition with a substantial impact on the quality of life. FFI diagnosis relies primarily on medical history and thorough physical examination and is categorized by the Rome IV criteria into functional constipation (FC) and functional nonretentive fecal incontinence (FNRFI). Treatment options for FFI remain limited, particularly for FNRFI.
View Article and Find Full Text PDFCureus
November 2024
General Surgery, Lady Reading Hospital Medical Teaching Institution (MTI), Peshawar, PAK.
Introduction An anal fissure is marked by a longitudinal tear in the mucosal lining of the lower anal canal, causing painful defecation and mild anal bleeding. The classical triad includes an anal ulcer, a sentinel tag, and a hypertrophic papilla. This study investigates the frequency of fecal incontinence in patients with anal fissure undergoing closed internal sphincterotomy, offering recent insights for treatment recommendations.
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