Table 7.
Characterization of selected studies on the effects of electrostimulation (ES) on the severity of fecal incontinence symptoms.
| Reference | Main Objective | Participants | Intervention | Outcome |
|---|---|---|---|---|
| Naimy et al. (2007), Norway [53] A randomized controlled trial study |
Comparison of the effect of BF vs. ES in the treatment of postdelivery FI. | 49 women with FI (≥3rd degree of perineal tears) (aged 22–44 years) BF: 24 ES: 25 |
2 sessions with a therapist, and then twice a day for 8 weeks at home. BF: 30 min, 5 sets of 3 s, 10 s and as long as it can be kept with a minimum 50 percent of amplitude of the three-second contraction ES: with anal probe; frequency 30–40 Hz, pulse width: 200 ms, up to 80 mAmp, time: 20 min. Assessment: Wexner score, FIQL, RQL |
No improvement was observed after BF or ES therapy in FI symptoms (Wexner score) and quality of life (FIQL) in women with postdelivery FI problem. Both therapies improved the subjective perception of fecal incontinence control by patients. |
| Worsøe (2011), Denmark [63] A prospective descriptive study |
Assessment of the effects of DGN stimulation on FI symptoms. | Nine women with idiopathic FI (median age, 60 years; 34–68 years) |
ES: twice a day for 3 weeks; 15 min, pulse width 200 μs; frequency 20 Hz. Assessment: VAS, FIQL, bowel habit diary, EA USG, Wexner score, St. Mark’s scale, manometry |
After electrostimulation of DGN, the symptoms of FI were reduced (Wexner score, St. Mark’s scale), and the effect was maintained also 3 weeks after the end of treatment. |
| Mahony et al. (2004), Ireland [54] A randomized controlled trial study |
Comparison of the effectiveness of intra-anal EMG-BF with intra-anal EMG-BF combined with anal sphincter ES in the treatment of postpartum FI, as well as QoL of treated patients. | 54 women with FI after obstetric injury BF + ES: 28 (median age 35 years, range 23–39), BF: 26 (median age 32 years, range 22–42) |
In both groups: daily PFMT for 12 weeks BF + ES: PFEs with EMG-BF or intra-anal BF and intra-anal electrical stimulation for 20 min, once per week. BF: PFEs with EMG-BF or intra-anal BF once per week. Assessment: FIQL, questionnaire to determine continence score, manometry, EA USG |
In both groups, there was significant improvement in FI symptoms and quality of life. ES did not bring any additional benefits. |
| Healy et al. (2006), Ireland [55] A prospective study |
Comparison of the effectiveness of home and hospital therapy using low-frequency endoanal electrostimulation in alleviating FI symptoms. | 38 women with FI (mean age: 55 years; range 40–78) G.I: 21 G.II: 17 |
G.I: low-frequency endo-anal ES at home with sequence of 3, 10, 20, 30, 40, 10 Hz frequencies (4 s on/4 s off), 1 h daily for 3 months G.II: low frequency endo-anal ES (15 min 10 Hz + 15 min 40 Hz) with biofeedback; 2 series 15 min; once a week under the supervision of a physiotherapist for 3 months Assessment: manometry, Wexner score, QoL |
Low-frequency ES significantly reduced the symptoms of FI and improved quality of life. Daily use of home ES significantly improved rectal pressure (resting and squeeze pressure). |
| Cohen-Zubary et al. (2015) Israel [56] A randomized controlled trial study |
Comparison of the effectiveness and costs of ES at home with BF training in women with FI. | 36 women with chronic FI (mean age: 67.45 ± 7.2 years) ES: 18 (mean age: 66.6 ± 6.6) BF + PFMT: 18 (mean age: 68.3 ± 6.9) |
ES: stimulation twice daily (25 min) for 6 weeks BF + PFMT: once a week supervised PFMT with BF (30–45 min) for 6 weeks and PFMT at home twice a day, 3 series, 10 contractions for 10 s. Assessment: VAS, VIS, HADS, intra-anal surface EMG |
In both groups there was an increase in muscle strength as well as a decrease in FI symptoms. There were no adverse side effects. |
G., group; FI, fecal incontinence; FIQL, fecal incontinence quality of life; RQL, reduced quality of life (on visual analog scale of 0 to 10); QoL, quality of life; DGN, dorsal genital nerve; EA USG, endoanal ultrasonography; ES, electrical stimulation; BF, biofeedback; VIS, Vaizey incontinence score; VAS, visual analog scale; HADS, Hospital Anxiety and Depression Scale; PFMT, pelvic floor muscle training; EMG-BF, electromyographic biofeedback; PFEs, pelvic floor electrostimulation.