Electrical stimulation of the dorsal clitoral nerve in the treatment of idiopathic defecatory urgency. A pilot study.

PURPOSE: To investigate the effect of dorsal clitoral nerve stimulation (DCNS) on bothersome urgency to defecate with or without fecal incontinence and the patient-reported discomfort or adverse effect with the method. METHODS: For dorsal clitoral nerve stimulation, a battery powered, handheld stimulator was used, set to a pulse width of 200 µs and a frequency of 20 Hz. One electrode was placed at the preputium of the clitoris and acted as cathode while an anode electrode was placed on the belly. Prior to stimulation the patients were asked to complete a bowel habit diary throughout 14 consecutive days before and during stimulation. RESULTS: Fourteen out of the 16 patients included completed the study. A decrease in the number of episodes (per day) with strong urgency declined in eight patients but increased in four cases during the stimulation period. An increase in episodes with moderate or mild urgency was observed in 11 and 6 cases, respectively, and a decrease in defecation without the feeling of urgency or passive incontinence decreased in two thirds of the patients. Two patients discontinued the study prematurely, on due to worsening in symptoms and one due to pelvic pain. CONCLUSION: Although the results may be promising, much still must be learned about the method including mode and duration of stimulation, better electrodes and more patient friendly equipment together with the development of better questionnaires to assess the patient burden of urgency.

[Otitis externa among users of private swimming pools]. / Otitis externa blandt brugere af private svømmebade.

The purpose of this study was to detect risk factors for developing otitis externa (OE) with special regard to swimming in private pools in holiday houses. Data were collected in a retrospective case-control study from June to October in 1993 and over the same period in 1994. Patients who had OE diagnosed by a general practitioner were included. In 1993 controls were 134 guests from 27 holiday houses where nobody got o.e. during their stay. The number of cases was 35. In 1994 the design was changed so that controls were the 95 healthy inhabitants from the same houses as the 23 cases. The amounts of time spent in the pools and the total bacteria count in the water were significant risk factors for developing OE. Pseudomonas aeruginosa was found in 80% of the ear swabs of the casegroup. In 1993 30% and in 1994 83% of the pools fulfilled the requirements for public pools set by the Danish authorities.