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1.
Dis Colon Rectum ; 63(2): 207-216, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31914113

RESUMO

BACKGROUND: Functional outcomes following J-pouch for ulcerative colitis have been studied, but lack standardization in which symptoms are reported. Furthermore, the selection of symptoms studied has not been patient centered. OBJECTIVE: This study aimed to utilize a validated bowel function survey to determine which symptoms are present after J-pouch creation, and whether patients display a functional profile similar to low anterior resection syndrome. DESIGN: This study is a retrospective analysis of a prospectively maintained single-center database. SETTINGS: This study was conducted at the colorectal surgery center of a tertiary care academic hospital PATIENTS:: Included were 159 patients with J-pouch, ≥6 months after ileostomy reversal. MAIN OUTCOME MEASURES: The primary outcomes were individual answers to the Memorial Sloan Kettering Cancer Center Bowel Function Instrument. The original Bowel Function Instrument validation cohort was used as an historical comparison (n = 127). RESULTS: The mean total Bowel Function Instrument score for the J-pouch cohort was 59.9 ± 9.7 compared with a reported average score of 63.7 ± 11.6 for patients with low anterior resection in the validation cohort (p < 0.001), indicating worse bowel function in patients with J-pouch. When evaluating the Bowel Function Instrument subscales, patients with J-pouch reported frequency subscale scores of 18.2 ± 3.8, diet scores of 12.2 ± 3.8, and urgency scores of 15.9 ± 3.7, compared with 21.7 ± 4.5 (p < 0.001), 14.1 ± 3.7 (p < 0.001), and 15.0 ± 3.9 (p = 0.04) for patients undergoing rectal resection. Furthermore, 90.4% of patients with J-pouch state that they are sometimes, rarely, or never able to wait 15 minutes to get to the toilet. In addition, 56.4% of patients report having another bowel movement within 15 minutes of the last bowel movement, sometimes, always, or most of the time, and 50.6% of patients say that they sometimes, rarely, or never feel like their bowels have been totally emptied after a bowel movement. LIMITATIONS: This study is limited because it took place at a single center and the Bowel Function Instrument was only validated for patients undergoing rectal resection. CONCLUSIONS: Patients that undergo J-pouch surgery exhibit a constellation of bowel function symptoms that is more complex than fecal incontinence and frequency alone, despite the focus on these functional outcomes in the literature. See Video Abstract at http://links.lww.com/DCR/B73. LA FUNCIÓN INTESTINAL DESPUÉS DE LA BOLSA EN J PUEDE SER MÁS COMPLEJA DE LO QUE SE APRECIABA ANTERIORMENTE: UN ANÁLISIS EXHAUSTIVO PARA RESALTAR LAS BRECHAS DE CONOCIMIENTO EXISTENTES: Se han estudiado los resultados funcionales después de la bolsa en J para la colitis ulcerosa, pero carecen de estandarización en la que se informen los síntomas. Además, la selección de los síntomas estudiados no se ha centrado en el paciente.Utilizar una encuesta validada de la función intestinal para determinar qué síntomas están presentes después de la bolsa en J y si los pacientes muestran un perfil funcional similar al síndrome de resección anterior baja.Análisis retrospectivo de una base de datos de un solo centro mantenida prospectivamente.Centro de cirugía colorrectal de un hospital académico de atención terciaria.159 pacientes con bolsa en J, ≥6 meses después de la reversión de ileostomía.Instrumento para la función intestinal del "Memorial Sloan Kettering Cancer Center"; cohorte de validación original de instrumentos de función intestinal utilizada como comparación histórica (n = 127).La puntuación media total del instrumento de función intestinal para la cohorte de bolsa J fue 59.9 ± 9.7 en comparación con un puntaje promedio reportado de 63.7 ± 11.6 para pacientes con resección anterior baja en la cohorte de validación (p < 0.001), lo que indica peor función intestinal en pacientes con bolsa en J. Al evaluar las subescalas del instrumento de función intestinal, los pacientes con bolsa en J informaron puntuaciones de subescala de frecuencia de 18.2 ± 3.8, puntuaciones de dieta de 12.2 ± 3.8 y puntuaciones de urgencia de 15.9 ± 3.7, en comparación con 21.7 ± 4.5 (p < 0.001), 14.1 ± 3.7 (p < 0.001) y 15.0 ± 3.9 (p = 0.04) respectivamente para pacientes con resección rectal. Además, el 90.4% de los pacientes con bolsa en J afirman que a veces, rara vez o nunca pueden esperar 15 minutos para llegar al baño. Además, el 56.4% de los pacientes reportan haber tenido otra evacuación intestinal dentro de los 15 minutos posteriores a la última evacuación intestinal, a veces, siempre o la mayor parte del tiempo, y el 50.6% de los pacientes dicen que a veces, rara vez o nunca sienten que sus intestinos han sido vaciados totalmente después de una evacuación intestinal.Estudio en un solo centro, instrumento de función intestinal validado solo para pacientes con resección rectalLos pacientes que se someten a una bolsa en J exhiben una constelación de síntomas de la función intestinal que es más compleja que la incontinencia fecal y la frecuencia sola, a pesar del enfoque en estos resultados funcionales en la literatura.Consulte Video Resumen en http://links.lww.com/DCR/B73. (Traducción-Dr. Gonzalo Federico Hagerman).


Assuntos
Colite Ulcerativa/cirurgia , Bolsas Cólicas/efeitos adversos , Defecação/fisiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Análise por Conglomerados , Incontinência Fecal/epidemiologia , Feminino , Humanos , Ileostomia/tendências , Masculino , Pessoa de Meia-Idade , Período Perioperatório/efeitos adversos , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença , Estados Unidos/epidemiologia
2.
BJOG ; 127(5): 619-627, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31872546

RESUMO

OBJECTIVE: To estimate the prevalence of flatus-only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over the first year postpartum. DESIGN: Cohort study from pregnancy to 12 months postpartum. SETTING: Two university hospital maternity wards in France. POPULATION: A total of 2002 pregnant women were recruited between 2003 and 2006. Data on anal incontinence were available for the 1632 women who comprise the sample for analysis. METHODS: Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12 months postpartum. MAIN OUTCOME MEASURES: Anal (flatus-only and faecal) incontinence was assessed at 4 months postpartum. Mental health was assessed at 4 and 12 months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self-rated mental health. RESULTS: At 4 months postpartum, the prevalence for flatus-only incontinence was 14.4% and for faecal incontinence 1.7%; multivariate analysis, restricted to women reporting no anal incontinence before the index pregnancy, showed that continuing breastfeeding at 4 months was related to a higher risk of de novo postpartum anal incontinence (OR = 2.23). Women who reported anal incontinence at 4 months were more frequently depressed (EPDS ≥10 or antidepressant use) at 12 months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus-only incontinence and only 14.8% of the continent women. CONCLUSION: Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered. TWEETABLE ABSTRACT: Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.


Assuntos
Incontinência Fecal/psicologia , Transtornos Puerperais/psicologia , Adulto , Antidepressivos/uso terapêutico , Aleitamento Materno , Estudos de Coortes , Depressão/tratamento farmacológico , Depressão/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Flatulência/epidemiologia , Flatulência/psicologia , França/epidemiologia , Humanos , Análise Multivariada , Transtornos Puerperais/epidemiologia , Inquéritos e Questionários
3.
World J Gastroenterol ; 25(31): 4414-4426, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31496621

RESUMO

Inflammatory bowel diseases (IBD), Crohn`s disease and ulcerative colitis, are chronic conditions associated with high morbidity and healthcare costs. The natural history of IBD is variable and marked by alternating periods of flare and remission. Even though the use of newer therapeutic targets has been associated with higher rates of mucosal healing, a great proportion of IBD patients remain symptomatic despite effective control of inflammation. These symptoms may include but not limited to abdominal pain, dyspepsia, diarrhea, urgency, fecal incontinence, constipation or bloating. In this setting, commonly there is an overlap with gastrointestinal (GI) motility and absorptive disorders. Early recognition of these conditions greatly improves patient care and may decrease the risk of mistreatment. Therefore, in this review we describe the prevalence, diagnosis and treatment of GI motility and absorptive disorders that commonly affect patients with IBD.


Assuntos
Dor Abdominal/epidemiologia , Constipação Intestinal/epidemiologia , Diarreia/epidemiologia , Dispepsia/epidemiologia , Incontinência Fecal/epidemiologia , Doenças Inflamatórias Intestinais/complicações , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Dor Abdominal/terapia , Constipação Intestinal/diagnóstico , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Diarreia/diagnóstico , Diarreia/etiologia , Diarreia/terapia , Dispepsia/diagnóstico , Dispepsia/etiologia , Dispepsia/terapia , Incontinência Fecal/diagnóstico , Incontinência Fecal/etiologia , Incontinência Fecal/terapia , Motilidade Gastrointestinal/fisiologia , Humanos , Doenças Inflamatórias Intestinais/fisiopatologia , Doenças Inflamatórias Intestinais/terapia , Prevalência , Índice de Gravidade de Doença
4.
Medicine (Baltimore) ; 98(32): e16777, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393401

RESUMO

OBJECTIVE: To analyze the clinical results of transanal endorectal pull-through (TERPT) and transabdominal approach (TAB) in the treatment of Hirschsprung disease. METHODS: We searched all publications in the PubMed, MEDLINE, EMBASE, and Cochrane library databases between January 2003 and November 2018. The study included randomized controlled trials (RCTs) and observational clinical studies (OCSs), to compare the surgery duration, length of postoperative hospital stay, incidence of postoperative incontinence/soiling, constipation, and enterocolitis between the TERPT and TAB groups. Mantel-Haenszel method was used for continuous variables, the combined odds ratios (ORs) and 95% confidence intervals (CIs) for dichotomous variables were used. RESULTS: In the 87 studies, we include 1 case of RCTs and 9 cases of OCSs. Including 392 cases of TERPT and 332 cases of TAB groups. TERPT has a short postoperative hospitalization [mean difference (MD) = -6.74 day; 95% CIs; -13.26 to -0.23; P = .04], and a low incidence of postoperative incontinence (ORs = 0.54; 95% CIs, 0.35-0.83; P = .006) and constipation (ORs = 0.50; 95% CIs, 0.28-0.90; P = .02). There was no difference in duration of surgery (MD = -30.59 min; 95% CIs, -98.01-36.83; P = .37) and incidence of postoperative enterocolitis (ORs = 0.78; 95% CIs, 0.53-1.17; P = .23). CONCLUSION: TERPT is superior to TAB in terms of hospitalization time, postoperative incontinence, and constipation. However, there are still a large number of RCTs to verify, and more trials are expected to be testified in the future.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Doença de Hirschsprung/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Complicações Pós-Operatórias/epidemiologia , Pré-Escolar , Constipação Intestinal/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Enterocolite/epidemiologia , Incontinência Fecal/epidemiologia , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Duração da Cirurgia
5.
J Wound Ostomy Continence Nurs ; 46(4): 285-290, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276451

RESUMO

PURPOSE: To evaluate prevalence and risk factors of incontinence-associated dermatitis (IAD). DESIGN: Retrospective analysis of 2016 International Pressure Ulcer Prevalence survey data. SUBJECTS AND SETTING: Adult patients who were in acute care, long-term acute care, long-term care, and rehabilitation facilities in the United States and Canada. METHODS: IAD prevalence was calculated among all patients surveyed, among the incontinent patients only, across multiple care settings, and by incontinence type. A logistic regression examined risk factors for IAD in the incontinent population. RESULTS: Nearly 1 in 5 incontinent patients had IAD documented. Incontinence-associated dermatitis prevalence in the entire patient population was 4.3% while incontinence prevalence was 18%. Of incontinent patients, prevalence of IAD ranged from 8.4% in long-term care facilities to 19% in acute care facilities. Facilities with higher rates of incontinence did not necessarily have higher prevalence of IAD. Incontinence-associated dermatitis prevalence by incontinence type ranged from 12% for patients with urinary incontinence to 26% for patients with fecal management systems. Regression results support the association of the following factors with an increased likelihood of IAD documented: all types of incontinence, fecal management systems, higher body weight, diminished mobility, additional linen layers, longer length of stay, and lower Braden Scale scores. CONCLUSIONS: Incontinence-associated dermatitis remains a concern in acute care settings. Risk factors associated with IAD were similar to risk factors previously reported for hospital-acquired pressure injuries, such as limited mobility, longer lengths of stay, and additional linen layers. By consistently documenting IAD as well as pressure injury prevalence, facilities may benchmark overall skin prevention models.


Assuntos
Dermatite/etiologia , Incontinência Fecal/complicações , Incontinência Urinária/complicações , Idoso , Idoso de 80 Anos ou mais , Canadá/epidemiologia , Dermatite/classificação , Dermatite/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Humanos , Modelos Logísticos , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia , Incontinência Urinária/epidemiologia
6.
Dis Colon Rectum ; 62(9): 1095-1104, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31318774

RESUMO

BACKGROUND: In the literature on chronic spinal cord injury, neurogenic bowel dysfunction has not gained as much attention as bladder dysfunction, the traditional cause of morbidity and mortality. OBJECTIVE: The purpose of this study was to investigate the prevalence of fecal incontinence and conditions associated with fecal incontinence in women with spinal cord injury. DESIGN: In this cross-sectional study, data were obtained from an electronic medical chart database containing standardized questionnaires. SETTINGS: The study was conducted at the Clinic for Spinal Cord Injuries, Rigshospitalet, where patients from Eastern Denmark are followed every second year. PATIENTS: Women who sustained a spinal cord injury between September 1999 and August 2016 and attended a consultation between August 2010 and August 2016 were included. If the bowel function questionnaire had never been answered, the woman was excluded. MAIN OUTCOME MEASURES: The newest completed questionnaire regarding bowel function, urinary bladder function, quality of life, neurologic level/completeness/etiology of injury, mobility status, and spousal relationship was obtained from each woman. RESULTS: Among the 733 identified women, 684 were included, of whom only 11% had a complete motor injury. A total of 35% experienced fecal incontinence, varying from daily to less than monthly, and 79% experienced bowel dysfunction. Fecal incontinence was associated with urinary incontinence and decreased satisfaction with life in general and psychological health. In the multivariate logistic regression analysis, the odds of daily-monthly fecal incontinence increased significantly with increasing age, myelomeningocele as etiology of injury, a more complete paraplegic injury, use of wheelchair permanently, and follow-up <3 months. LIMITATIONS: There were missing data in the study, including 12% with no answer to the fecal incontinence question. CONCLUSIONS: Fecal incontinence is a severe problem that affects more than one third of women with spinal cord injury and is associated with decreased quality of life. The present study emphasizes that women with myelomeningocele, a more complete paraplegic injury, older age, short follow-up period, and permanent wheelchair use have an increased risk of fecal incontinence. See Video Abstract at http://links.lww.com/DCR/A985. INCONTINENCIA FECAL Y DISFUNCIÓN NEUROGÉNICA DEL INTESTINO EN MUJERES CON LESIÓN DE LA MEDULA ESPINAL TRAUMÁTICA Y NO TRAUMÁTICA: En la literatura sobre la lesión crónica de la médula espinal, la disfunción neurógena del intestino no ha ganado tanta atención como la disfunción de la vejiga, la causa tradicional de morbilidad y mortalidad. OBJETIVÓ:: Investigar la prevalencia de la incontinencia fecal y las condiciones asociadas con la incontinencia fecal en mujeres con lesión de la médula espinal. DISEÑO:: En este estudio transversal, los datos se obtuvieron de una base de datos de registros médicos electrónicos que contenía cuestionarios estandarizados. CONFIGURACIÓN:: Clínica para Lesiones de la Médula Espinal, Rigshospitalet, donde los pacientes del Este de Dinamarca son seguidos cada dos años. PACIENTES: Mujeres que sufrieron una lesión en la médula espinal entre Septiembre de 1999 a Agosto de 2016 y asistieron a una consulta entre Agosto de 2010 a Agosto de 2016. Si nunca se había respondido el cuestionario de la función intestinal, se excluyó a la mujer. MEDIDA DE RESULTADOS PRINCIPALES: Se obtuvo el cuestionario más reciente y completo sobre la función intestinal, la función de la vejiga urinaria, la calidad de vida, el nivel neurológico/integridad/etiología de la lesión, el estado de movilidad y la relación con el cónyuge. RESULTADOS: Entre las 733 mujeres identificadas, se incluyeron 684, de las cuales solo el 11% tenía una lesión de motor completa. Un total de 35% experimentó incontinencia fecal que varió de diaria a menos de mensual, y el 79% experimentó disfunción intestinal. La incontinencia fecal se asoció con incontinencia urinaria y disminución de la satisfacción de vida en general y con la salud psicológica. En el análisis de regresión logística multivariable, las probabilidades de incontinencia fecal diaria-mensual aumentaron significativamente con el aumento de la edad, el mielomeningocele como etiología de la lesión, una lesión parapléjica más completa, el uso de silla de ruedas de forma permanente y el seguimiento <3 meses. LIMITACIONES: Faltaban datos en el estudio, incluyendo el 12% sin respuesta a la pregunta sobre incontinencia fecal. CONCLUSIONES: La incontinencia fecal es un problema grave que afecta a más de un tercio de las mujeres con lesión de la médula espinal y se asocia con una disminución de calidad de vida. El presente estudio enfatiza que las mujeres con mielomeningocele, una lesión parapléjica más completa, mayor edad, corto período de seguimiento y uso de silla de ruedas permanente tienen un mayor riesgo de incontinencia fecal. Vea el Video del Resumen en http://links.lww.com/DCR/A985.


Assuntos
Incontinência Fecal/etiologia , Intestino Neurogênico/etiologia , Traumatismos da Medula Espinal/complicações , Adulto , Estudos Transversais , Dinamarca/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Morbidade/tendências , Intestino Neurogênico/epidemiologia , Qualidade de Vida , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Inquéritos e Questionários , Taxa de Sobrevida/tendências
7.
Taiwan J Obstet Gynecol ; 58(4): 505-513, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31307742

RESUMO

OBJECTIVES: This study aims to compare pelvic floor muscle (PFM) functions in midwifes and nurses of reproductive age with and without pelvic floor dysfunction (PFD) and investigate the relationship between PFM function and the number, type and symptoms of PFDs. MATERIALS AND METHODS: 82 midwifes and nurses of reproductive age with (n = 51) and without PFD (n = 31) participated in the study. PFM function was assessed by digital palpation using PERFECT scale. Gynecological examination, ultrasonography, disease-specific questionnaires, questions and tests were used to assess symptoms of PFD. PFD was assessed in terms of risk factors, urinary incontinence, fecal incontinence, pelvic organ prolapse (POP), pelvic pain and sexual dysfunctions. RESULTS: Power parameter of PERFECT scheme was significantly lower in subjects with PFD compared to Non-PFD group (p = 0.002). 41% of the subjects with Power 5 PFM strength in PFD group were diagnosed as stage 1 POP, 5.8% as stage 2 POP, 15.7% of urge incontinence, 23.3% of stress incontinence and 10.5% of mixed incontinence. Both urinary incontinence and POP were detected in 15.7% of them. Among all subjects, incontinence symptoms decreased whereas POP and sexual function did not change as PFM increased. PFM strength was negatively correlated with the number of PFD (p = 0.002, r = -0.34). The type of dysfunction did not correlate with PFM strength (p > 0.05). CONCLUSION: PFM strength only affects of urinary incontinence sypmtoms among all PFDs in midwifes and nurses of reproductive age. PFM strength may not be the main factor in the occurrence of PFDs as pelvic floor does not consist solely of muscle structure. However, it strongly affects the number of dysfunctions. Therefore, PFM training should be performed to prevent the occurrence of extra dysfunctions in addition to the existing ones even if it does not alter the symptoms.


Assuntos
Incontinência Fecal/fisiopatologia , Prolapso de Órgão Pélvico/complicações , Inquéritos e Questionários , Incontinência Urinária/fisiopatologia , Adulto , Fatores Etários , Estudos Transversais , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Feminino , Exame Ginecológico/métodos , Humanos , Incidência , Pessoa de Meia-Idade , Tocologia , Força Muscular/fisiologia , Enfermeiras e Enfermeiros , Diafragma da Pelve/fisiopatologia , Distúrbios do Assoalho Pélvico/complicações , Distúrbios do Assoalho Pélvico/diagnóstico , Prolapso de Órgão Pélvico/diagnóstico , Prolapso de Órgão Pélvico/terapia , Prognóstico , Medição de Risco , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
8.
Ceska Gynekol ; 84(1): 18-22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213053

RESUMO

OBJECTIVE: Analysis of women undergoing vaginal birth with 3rd or 4th degree perineal tears. TYPE OF STUDY: Review and analysis of the data from our department. SETTING: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce, Prague. INTRODUCTION: Obstetric anal sphincter injuries (OASIS) belong to dreaded complications after vaginal delivery. The injury is associated with significant maternal morbidity. The most common difficulties are perineal pain, dyspareunia, flatulence and anal incontinence. OASIS are main cause of anal incontinence in women. MAIN RESULTS: During monitored period 2015-2017 we performed 6185 childbirths in our ward. Cesarean section was performed at 21% of births, instrumental vaginal birth at 5,7% and 73,3% of women had a spontaneous vaginal birth. Our analysis included 4888 births. In our group 92,8% of women gave birth spontaneously regardless of injury and at 7,2% we performed an instrumental delivery. Perineal tears of 3rd and 4th degree were detected in 1,7% (83/4888) of vaginal births independent of vaginal ending. 85,5% were nulliparous women. In a group of instrumental deliveries the risk of OASI was higher. We have detected injury at 5,4% (19/352) of this type of delivery. The most detected perineal trauma in 47% was injury involving more than 50% of external anal sphincter thickness torn (3b). Surprising was a high incidence of mediolateral episiotomy in a group of women who sustained OASI. The most frequent symptoms three months after birth were flatus incontinence and dyspareunia. CONCLUSION: Obstetric anal sphincter injury is associated with significant maternal morbidity. The most serious consequence is an anal incontinence. With other symptoms as a dyspareunia and a perineal pain it leads to psychosocial problems. Thorough treatment reduces the risk of complications.


Assuntos
Canal Anal/lesões , Cesárea/estatística & dados numéricos , Parto Obstétrico/métodos , Incontinência Fecal/etiologia , Lacerações/complicações , Complicações do Trabalho de Parto/etiologia , Períneo/lesões , Episiotomia/métodos , Incontinência Fecal/epidemiologia , Feminino , Humanos , Lacerações/epidemiologia , Complicações do Trabalho de Parto/epidemiologia , Gravidez , Fatores de Risco
9.
Ann Surg ; 269(6): 1124-1128, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31082911

RESUMO

OBJECTIVE: To provide normative data for the Low Anterior Resection Syndrome (LARS) score. BACKGROUND: The LARS score is a validated and frequently used tool measuring bowel dysfunction after sphincter sparing surgery for rectal cancer. The interpretation of LARS score results has previously been limited by the lack of normative data. METHODS: An age and sex-stratified random sample of 3440 citizens from the general population was drawn from the Danish civil registration system (age range 20-89 years, 50% females). A brief questionnaire including the LARS score and health-related items were distributed electronically or by post. RESULTS: A total of 1875 (54.5%) responded, 54.0% were females. In the age group 50 to 79 years, relevant for most rectal cancer studies, the response rate was 70.5% (n = 807). In this specific age group, 18.8% of the females and 9.6% of the males had a LARS score ≥30, corresponding to the LARS score category "major LARS" (P = 0.001), and the median (interquartile range) LARS score was 16 (7-26) and 11 (4-22), respectively (P < 0.001). Responders with physical disease had a statistically significant higher risk of a LARS score ≥30, compared with responders without any physical disease (odds ratio 2.2, 95% confidence interval 1.6-2.9, P < 0.001). CONCLUSIONS: A LARS score ≥30 (major LARS) is common in the general population, especially in the age group 50 to 79 years. Normative data for the LARS score are now available and can be taken into account when interpreting LARS score results in scientific studies of bowel function after rectal cancer treatment.


Assuntos
Incontinência Fecal/epidemiologia , Flatulência/epidemiologia , Tratamentos com Preservação do Órgão/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Protectomia/efeitos adversos , Neoplasias Retais/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Canal Anal , Dinamarca , Incontinência Fecal/diagnóstico , Feminino , Flatulência/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Prevalência , Fatores Sexuais , Síndrome , Adulto Jovem
10.
World Neurosurg ; 127: e124-e131, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30862584

RESUMO

BACKGROUND: Accurate survival estimate is necessary when determining the most appropriate treatment modality for metastatic spinal tumor. The main purpose of this study was to identify the prognostic factors of spinal metastasis and establish a decision tree model. METHODS: A consecutive cohort of 507 patients from 3 institutional clinical centers who were treated for metastatic spinal tumor between 2005 and 2015 were retrospectively reviewed. In total, 70% of the participants were randomly selected as a "training sample." The prognostic effect of preoperative factors was evaluated using the "training sample," and a decision tree model was established. Then, the accuracy of the new model, as well as the Tokuhashi and Tomita score, was tested by the "test sample," which consisted of the remaining 30% of participants. RESULTS: A decision tree model was generated based on the significant factors with an order of descending importance on predicting the prognosis. According to the new model, patients were classified into 3 groups, mean survival times of less than 6 months, 6-12 months, and more than 12 months, who were indicated for conservative therapy/palliative operation, palliative operation, and invasive excision, respectively. The newly established model was confirmed to be of high accuracy in predicting overall survival, whereas the Tokuhashi and Tomita scores were of modest accuracy and consistency. CONCLUSIONS: A new decision tree model for prognosis prediction in spinal metastasis was established with a satisfactory accuracy and consistency. However, the Tokuhashi and Tomita systems were presented to be less correlated between the scores and actual survival.


Assuntos
Tomada de Decisão Clínica/métodos , Índice de Gravidade de Doença , Neoplasias da Coluna Vertebral/mortalidade , Neoplasias da Coluna Vertebral/secundário , Idoso , Conservadores da Densidade Óssea/uso terapêutico , Quimioterapia Adjuvante , Terapia Combinada , Árvores de Decisões , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Feminino , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Procedimentos Neurocirúrgicos , Cuidados Paliativos , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/terapia , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
11.
J Wound Ostomy Continence Nurs ; 46(3): 201-206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870318

RESUMO

PURPOSE: The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) upon admission, and the incidence of hospital-acquired IAD and ITD in a sample of acutely ill adults. DESIGN: This was a descriptive, retrospective-cohort observational study. SUBJECTS AND SETTING: The sample comprised 417 adults admitted to an urban community hospital licensed for 249 acute and 52 acute rehabilitation beds in Charleston, South Carolina, and referred to WOC nurses for evaluation and treatment. METHODS: Prevalence and incidence rates were calculated from data previously collected for quality improvement purposes from January 1, 2014, to December 31, 2016, by the WOC nurses and documented in a secure, password-protected electronic spreadsheet. The prevalence of IAD/ITD was calculated as the proportion of patients diagnosed with IAD/ITD on admission to our facility. The incidence of IAD and ITD was calculated as percentage of patients who developed IAD/ITD during the course of their hospital stay. All units in the hospital were included. RESULTS: The mean prevalence of IAD present on admission was 16%; the prevalence decreased over the data collection period; it was 21% in 2014, 15% in 2015, and 13% in 2016. The mean incidence of hospital-acquired IAD during the data collection period was 23%; the highest rate (26%) occurred in 2016. Patients classified as normal weight from their body mass index and patients 60 years and older had the highest incidence of hospital-acquired IAD. The mean prevalence of ITD for patients admitted to the hospital was 40% for the 3-year time; annual rates varied from a low of 36% in 2015 to a high of 42% in 2016. The mean incidence of hospital-acquired ITD was 33% over the data collection period; mean incidence rates were 32% in 2014, 39% in 2015, and 29% in 2016. The incidence of ITD was higher in patients classified as obese based on body mass index in patients 60 years and older. The most common location was the gluteal cleft. CONCLUSIONS: The prevalence of IAD fell within the range of prior epidemiologic studies, but the facility-acquired IAD incidence rates were higher than other studies based in the acute care setting. The prevalence of ITD was higher than rates reported in prior studies; we searched the literature and found no previous reports of ITD occurrences over the course of a hospital stay. Additional research regarding IAD prevention and ITD in the gluteal cleft is needed. Data collection regarding IAD and ITD prevalence and incidence could be incorporated into the data collection tool used for pressure injury data collection for the National Database of Nursing Sensitive Indicators.


Assuntos
Dermatite/etiologia , Incontinência Fecal/diagnóstico , Incontinência Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Dermatite/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/epidemiologia , Prevalência , Estudos Retrospectivos , Higiene da Pele/normas , South Carolina/epidemiologia , Incontinência Urinária/epidemiologia
12.
Arch Gerontol Geriatr ; 82: 226-231, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30875524

RESUMO

OBJECTIVE: The aim of this study was to analyse the prevalence of pelvic floor disorders and to describe health-related quality of life (HRQoL) among older women. We also compared participants' HRQoL with the age-matched general female population and analysed factors associated with HRQoL. STUDY DESIGN: This is a population-based study of a cohort of women born in 1948 and in 1950 (n = 143) which is also part of the Women's Gynaecological Health study in Lieto, Finland. METHODS: The data were collected by questionnaires which pertained to socio-demographics, health-related variables, pelvic floor disorders and HRQoL (15D). Linear model was conducted to estimate a model of factors that associated with HRQoL. RESULTS: The prevalence of urinary incontinence, faecal incontinence and pelvic organ prolapse was 50%, 13% and 12%, respectively. The overall HRQoL score of the study cohort is broadly similar to that of the agematched general Finnish female population (mean±SD15D scores 0.905±0.084 vs 0.912±0.077). Higher number of medications was the most important explanatory factor for lower HRQoL. CONCLUSION: Urinary incontinence was common; however, the impact on HRQoL was minor. The overall HRQoL score of the study cohort was broadly similar to that of age-matched general female population. Women who used a higher number of medications had lower HRQoL compared to women who used fewer medications.


Assuntos
Distúrbios do Assoalho Pélvico/psicologia , Qualidade de Vida , Idoso , Incontinência Fecal/epidemiologia , Feminino , Humanos , Prolapso de Órgão Pélvico/epidemiologia , Prevalência , Incontinência Urinária/epidemiologia , Saúde da Mulher
13.
Dig Liver Dis ; 51(7): 961-966, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30826278

RESUMO

BACKGROUND: Inflammatory bowel diseases (IBD) affect working-age patients. Data was lacking concerning the impact on working life. AIMS: The French IBD patient association conducted a nationwide survey to assess the burden of IBD at work. METHODS: An online survey was performed in 2016, targeting IBD patients working or having worked previously. The results were compared to those observed in the general population. RESULTS: Data from 1410 IBD patients were analyzed (62% Crohn's disease, 35% ulcerative colitis). Four-fifth of respondents were actively employed. Half of them stated that working with IBD was a problem. Compared to the general population, IBD employees had higher rates of permanent contracts, public employment but also of part-time contracts, and highly graduated patients were less likely to reach high qualified jobs. Among the disabling symptoms at work, fatigue was the most frequent (41%) followed by diarrhea (25%) and fecal incontinence (18%). Despite these difficulties, 76% were satisfied with their job. Most patients shared their IBD diagnosis with their colleagues, but 25% of them regretted it. CONCLUSION: IBD has a strong negative impact on working life. While work satisfaction remains high, IBD affects career plans, highlighting the need for supporting measures to improve patients' work experience.


Assuntos
Emprego/estatística & dados numéricos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/psicologia , Satisfação do Paciente/estatística & dados numéricos , Qualidade de Vida , Adolescente , Adulto , Mobilidade Ocupacional , Diarreia/epidemiologia , Emprego/psicologia , Fadiga/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações/classificação , Inquéritos e Questionários , Adulto Jovem
14.
J Pediatr Surg ; 54(6): 1159-1163, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30898398

RESUMO

PURPOSE: The purpose of this study was to identify factors associated with attaining fecal continence in children with anorectal malformations (ARM). METHODS: We performed a multi-institutional cohort study of children born with ARM in 2007-2011 who had spinal and sacral imaging. Questions from the Baylor Social Continence Scale were used to assess fecal continence at the age of ≥4 years. Factors present at birth that predicted continence were identified using multivariable logistic regression. RESULTS: Among 144 ARM patients with a median age of 7 years (IQR 6-8), 58 (40%) were continent. The rate of fecal continence varied by ARM subtype (p = 0.002) with the highest rate of continence in patients with perineal fistula (60%). Spinal anomalies and the lateral sacral ratio were not associated with continence. On multivariable analysis, patients with less severe ARM subtypes (perineal fistula, recto-bulbar fistula, recto-vestibular fistula, no fistula, rectal stenosis) were more likely to be continent (OR = 7.4, p = 0.001). CONCLUSION: Type of ARM was the only factor that predicted fecal continence in children with ARM. The high degree of incontinence, even in the least severe subtypes, highlights that predicting fecal continence is difficult at birth and supports the need for long-term follow-up and bowel management programs for children with ARM. TYPE OF STUDY: Prospective Cohort Study. LEVEL OF EVIDENCE: II.


Assuntos
Malformações Anorretais , Incontinência Fecal , Malformações Anorretais/complicações , Malformações Anorretais/epidemiologia , Criança , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Humanos , Modelos Logísticos , Estudos Prospectivos
15.
Obstet Gynecol ; 133(4): 837-839, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30913191

RESUMO

Fecal incontinence, or the involuntary leakage of solid or loose stool, is estimated to affect 7-15% of community-dwelling women (). It is associated with reduced quality of life, negative psychologic effects, and social stigma (), yet many women do not report their symptoms or seek treatment. Less than 3% of women who do self-report fecal incontinence will have this diagnosis recorded in their medical record (). Obstetrician-gynecologists are in a unique position to identify women with fecal incontinence because pregnancy, childbirth, obstetric anal sphincter injuries (OASIS), and pelvic floor dysfunction are important risk factors that contribute to fecal incontinence in women. The purpose of this Practice Bulletin is to provide evidence-based guidelines on the screening, evaluation, and management of fecal incontinence to help obstetrician-gynecologists diagnose the condition and provide conservative treatment or referral for further work up and surgical management when appropriate. For discussion on fecal incontinence associated with OASIS, see Practice Bulletin No. 198, Prevention and Management of Obstetric Lacerations at Vaginal Delivery ().


Assuntos
Incontinência Fecal/diagnóstico , Incontinência Fecal/terapia , Promoção da Saúde/organização & administração , Complicações do Trabalho de Parto/epidemiologia , Guias de Prática Clínica como Assunto , Qualidade de Vida , Adulto , Fatores Etários , Idoso , Incontinência Fecal/epidemiologia , Incontinência Fecal/psicologia , Feminino , Ginecologia , Humanos , Incidência , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/diagnóstico , Obstetrícia , Gravidez , Medição de Risco , Índice de Gravidade de Doença , Sociedades Médicas
16.
BMC Pregnancy Childbirth ; 19(1): 94, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30871488

RESUMO

BACKGROUND: Obstetric anal sphincter injury (OASI) is one of the most severe obstetrical complications. Although risk factors for OASI have been identified, little is known about various parameters that can influence symptoms' severity. The aim of this study is to explore whether obstetrical and epidemiological factors can have an effect on the severity of symptoms after OASI. METHODS: 11.483 deliveries between January 2010 and December 2014 were reviewed, and data from 88 women with OASI are presented. RESULTS: The only statistically significant differences between symptomatic and asymptomatic women were age (p = 0.02), body mass index (p = 0.04) and the use of forceps (p = 0.04). Women with more severe symptoms were more likely to have received oxytocin during the second stage of labor (p = 0.03) and had shorter delivery to follow-up interval (p = 0.008). CONCLUSIONS: Modifiable factors such as use of forceps and oxytocin should be taken into consideration in clinical practice.


Assuntos
Canal Anal/lesões , Parto Obstétrico/efeitos adversos , Incontinência Fecal/epidemiologia , Complicações do Trabalho de Parto/epidemiologia , Transtornos Puerperais/epidemiologia , Adulto , Incontinência Fecal/etiologia , Feminino , Humanos , Complicações do Trabalho de Parto/etiologia , Gravidez , Transtornos Puerperais/etiologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
17.
Rev. argent. coloproctología ; 30(1): 1-10, mar. 2019. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1023345

RESUMO

La morbilidad y alteración de la calidad de vida asociadas a la resección anterior del recto y amputación abdominoperineal determinaron un gran interés en el desarrollo del abordaje transanal. En los últimos años se ha visto un marcado desarrollo tecnológico en los dispositivos disponible para este abordaje. La cirugía por vía transanal ofrece ventajas en cuanto a sus resultados y complicaciones cuando se la compara a la cirugía por vía abdominal. La cirugía transanal mini-invasiva surge como una alternativa de abordaje videoendoscópico del recto. La resección local por cirugía endoscópica para los pólipos grandes de recto se ha convertido en un nuevo estándar de tratamiento en la mayoría de los centros, obteniendo piezas no fragmentadas con una alta tasa de márgenes negativos. En el presente estudio realizamos una revisión sobre la aplicación de TAMIS (TransAnal Minimally Invasive Surgery) al tratamiento de los pólipos de recto. (AU)


A great interest has developed in implementing trans anal minimally invasive surgery for the treatment of rectal adenomas and early rectal tumors. It present advantages when compare to radical surgery and peace meal endoscopic resections. TAMIS delivers non-fragmented specimens with clear resection margin in the majority of the cases. Such good technical results are mirrored with a low recurrence rate when evaluating rectal adenomas. This is a review of the application of TAMIS for the treatment of rectal adenomas. (AU)


Assuntos
Humanos , Pessoa de Meia-Idade , Reto/cirurgia , Pólipos Intestinais/cirurgia , Pólipos Intestinais/epidemiologia , Cirurgia Endoscópica Transanal/instrumentação , Cirurgia Endoscópica Transanal/métodos , Complicações Pós-Operatórias , Qualidade de Vida , Neoplasias Retais/cirurgia , Neoplasias Retais/epidemiologia , Morbidade , Resultado do Tratamento , Sobreviventes , Incontinência Fecal/epidemiologia
18.
J Minim Invasive Gynecol ; 26(5): 816-825, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30708118

RESUMO

OBJECTIVE: To determine the effect of bariatric surgery (BS) on the prevalence of pelvic floor dysfunctions (PFD), specifically on urinary incontinence (UI), pelvic organ prolapse (POP), and fecal incontinence (FI). DATA SOURCES: A systematic review (PROSPERO registration no. CRD42017068452) with a literature search was performed using the PubMed, Scopus, and SciELO databases for all publications related to BS and PFD, with no language restrictions, from inception to September 2018. METHODS OF STUDY SELECTION: Two authors screened for study eligibility and extracted data. Only prospective cohorts assessing women with morbid obesity and the prevalence of PFD before and after BS in multiple academic and private centers were included. UI, POP, and FI were defined according to the International Urogynecological Association/International Continence Society joint consensus, and diagnosis was made based on self-report or questionnaires. TABULATION, INTEGRATION, AND RESULTS: Our search strategy retrieved 957 results. Of those, 28 studies were included for full analysis, and 20 studies (n = 3684 patients) were selected for final analysis. The main reasons for exclusion were missing data before and after BS (n = 7) and combined data of men and women who underwent BS (n = 1). Laparoscopic Roux-en-Y gastric bypass was the most common surgical technique. Pooled analysis (16 studies) showed that women had a mean body mass index reduction of 12.90 kg/m2 after treatment (95% confidence interval [CI], -14.82 to -10.97; p < .0001). The relative risk reduction was 67% (n = 19; odds ratio [OR], 0.33; 95% CI, 0.26-0.41; p < .0001) for UI, 52% (n = 5; OR, 0.48; 95% CI, 0.22-1.07; p = .07) for POP, and 20% (n = 9; OR, 0.80; 95% CI, 0.53-1.21; p = .29) for FI. Funnel plots for UI and FI did not suggest any publication bias. With regard to the standardized questionnaires for PFD, the International Consultation on Incontinence-Short Form, Pelvic Floor Impact Questionnaire-7 and its subscale Colorectal-Anal Impact Questionnaire-7, Pelvic Floor Distress Inventory-20, and its subscale Urinary Distress Inventory-6 showed statistically significantly lower scores. Sexual function, represented by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12, showed no statistically significant improvement after surgery. CONCLUSION: BS has a significant impact on reducing UI, but FI and POP, in obese women.


Assuntos
Cirurgia Bariátrica/métodos , Obesidade Mórbida/complicações , Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/complicações , Índice de Massa Corporal , Incontinência Fecal/epidemiologia , Feminino , Humanos , Obesidade Mórbida/cirurgia , Distúrbios do Assoalho Pélvico/epidemiologia , Distúrbios do Assoalho Pélvico/cirurgia , Prolapso de Órgão Pélvico/fisiopatologia , Prolapso de Órgão Pélvico/cirurgia , Prevalência , Estudos Prospectivos , Fatores de Risco , Comportamento Sexual , Inquéritos e Questionários , Incontinência Urinária/cirurgia , Perda de Peso
19.
Lancet ; 393(10177): 1233-1239, 2019 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-30799061

RESUMO

BACKGROUND: Elective caesarean delivery is increasing rapidly in many countries, and one of the reasons might be that caesarean delivery is widely believed to protect against pelvic floor disorders, including anal incontinence. Previous studies on this issue have been small and with conflicting results. The aim of present study was to compare the risk of developing anal incontinence in women who had a caesarean delivery, in those who had a vaginal delivery, and in two age-matched control groups (nulliparous women and men). METHODS: In this observational population-based study, we included all women in the Swedish Medical Birth Register who gave birth by caesarean delivery or vaginal delivery during 1973-2015 in Sweden and were diagnosed with anal incontinence according to ICD 8-10 in the Swedish National Patient Register during 2001-15. Exclusion criteria were multiple birth delivery, mixed vaginal and caesarean delivery, and four or more deliveries. We compared the diagnosis of anal incontinence between women previously delivered solely by caesarean delivery and those who solely had delivered vaginally. We also compared it with two age-matched control groups of nulliparous women and men from the Swedish Total Population Register. Finally, we analysed risk factors for anal incontinence in the caesarean delivery and vaginal delivery groups. FINDINGS: 3 755 110 individuals were included in the study. Between 1973 and 2015, 185 219 women had a caesarean delivery only and 1 400 935 delivered vaginally only. 416 (0·22 %) of the 185 219 women in the caesarean delivery group were diagnosed with anal incontinence compared with 5171 (0·37%) of 1 400 935 women in the vaginal delivery group. The odds ratio (OR) for being diagnosed with anal incontinence after vaginal delivery compared with caesarean delivery was 1·65 (95% CI 1·49-1·82; p<0·0001). When the combination vaginal delivery and caesarean delivery was compared with the nulliparous control group, the OR of being diagnosed with anal incontinence was 2·05 (1·92-2·19; p<0·0001). For the nulliparous women compared with men, the OR for anal incontinence was 1·89 (1·75-2·05; p<0·0001). The strongest risk factors for anal incontinence after vaginal delivery were high maternal age, high birthweight of the child, and instrumental delivery. The only risk factor for anal incontinence after caesarean delivery was maternal age. INTERPRETATION: The risk of developing anal incontinence increases after pregnancy and delivery. Women with known risk factors for anal incontinence should perhaps be offered a more qualified post-partum examination to enable early intervention in case of injury. Further knowledge for optimal management are needed. FUNDING: County Council of Jämtland.


Assuntos
Cesárea/efeitos adversos , Parto Obstétrico/efeitos adversos , Incontinência Fecal/etiologia , Distúrbios do Assoalho Pélvico/etiologia , Adulto , Peso ao Nascer , Cesárea/métodos , Parto Obstétrico/métodos , Incontinência Fecal/diagnóstico , Incontinência Fecal/epidemiologia , Feminino , Humanos , Masculino , Idade Materna , Distúrbios do Assoalho Pélvico/diagnóstico , Distúrbios do Assoalho Pélvico/epidemiologia , Gravidez , Fatores de Risco , Suécia/epidemiologia
20.
Medicine (Baltimore) ; 98(7): e14482, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30762773

RESUMO

BACKGROUND: Fecal incontinence is a socially and emotionally destructive condition that has a negative impact on personal image, self-confidence, and quality of life. Acupuncture is commonly used to treat chronic conditions, including fecal incontinence. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupuncture on fecal incontinence. METHODS: We will identify relevant randomized controlled trials (RCTs) from the Cochrane Library, Medline, Embase, PubMed, Springer, Web of Science, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, Wanfang database, and clinical trial registration center from their inception to February 28, 2019. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Data that meets the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Two reviewers will evaluate the studies using the Cochrane Collaboration risk of bias tool. Publication bias will be assessed by funnel plots, Egger test, and Begg test using the Stata software. Acupoints characteristics will be analyzed by Traditional Chinese Medicine inheritance support system. RESULTS: This study will analyze the clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, and effective prescriptions of acupuncture for patients with fecal incontinence. CONCLUSION: Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupuncture for patients with fecal incontinence. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019119680.


Assuntos
Terapia por Acupuntura/métodos , Incontinência Fecal/terapia , Projetos de Pesquisa , Adaptação Psicológica , Antidiarreicos/administração & dosagem , China , Mineração de Dados , Depressão/epidemiologia , Incontinência Fecal/tratamento farmacológico , Incontinência Fecal/epidemiologia , Humanos , Estilo de Vida , Qualidade da Assistência à Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto
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