Brusciano Luigi, Gambardella Claudio, Gualtieri Giorgia, Terracciano Gianmattia, Tolone Salvatore, Schiano di Visconte Michele, Grossi Ugo, Del Genio Gianmattia, Docimo Ludovico
Division of General, Mininvasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples Italy.
Division of General, Mini-invasive and Obesity Surgery- Master of Coloproctology and Master of Pelvi-Perineal Rehabilitation. University of Study of Campania "Luigi Vanvitelli" Naples, Italy.
Open Med (Wars). 2020 Jan 30;15:57-64. doi: 10.1515/med-2020-0009. eCollection 2020.
Fecal incontinence (FI) is a common condition that has devastating consequences for patients' QOL. In some patients, the conventional functional pelvic floor electrical stimulation has been effective but is an invasive and embarrassing treatment. The object of the study was to evaluate the feasibility of functional extracorporeal magnetic stimulation (FMS) in strengthening the pelvic floor muscles without an anal plug and the embarrassment of undressing.
Thirty patients (26 female and 4 males) with FI were enrolled. All patients were assessed during a specialized coloproctology evaluation followed by endoanal ultrasonography and anorectal manometry. All patients underwent an FMS treatment once weekly for 8 weeks. Patients' outcome was assessed by the Cleveland Clinic Fecal Incontinence Score (CCFIS) and by the fecal incontinence QOL questionnaire (FIQL).
After 8 weeks, the number of solid and liquid stool leakage per week was significantly reduced (p<0.05) with a significant improvement of the CCFIS and of the FIQL (p<0.05). Moreover, the authors recorded a missed recruitment of the agonist and antagonists' defecation muscles.
FMS is a safe, non-invasive and painless treatment for FI. It could be recommended for selected patients with non-surgical FI to ensure a rapid clinical improvement.
大便失禁（FI）是一种常见病症，会对患者的生活质量产生严重影响。对于一些患者而言，传统的功能性盆底电刺激虽有效果，但却是一种侵入性且令人尴尬的治疗方法。本研究的目的是评估功能性体外磁刺激（FMS）在不使用肛门塞且避免脱衣尴尬的情况下增强盆底肌肉的可行性。
招募了30例大便失禁患者（26例女性，4例男性）。所有患者均在专门的结肠直肠病学评估期间接受评估，随后进行肛门内超声检查和肛肠测压。所有患者每周接受一次FMS治疗，共8周。通过克利夫兰诊所大便失禁评分（CCFIS）和大便失禁生活质量问卷（FIQL）评估患者的治疗效果。
8周后，每周固体和液体粪便泄漏的次数显著减少（p<0.05），CCFIS和FIQL均有显著改善（p<0.05）。此外，作者记录到排便肌肉的主动肌和拮抗肌募集缺失。
FMS是一种治疗大便失禁的安全、非侵入性且无痛的方法。对于部分非手术治疗的大便失禁患者，推荐使用该方法以确保临床症状迅速改善。
