The Use of Electrical Stimulation to Increase Anal Pressures
Study Details
Study Description
Brief Summary
The goal of this clinical trial is to learn about the feasibility of inducing contraction of the anal sphincter by transcutaneous neuromuscular electrical stimulation in patients with fecal incontinence.
The main questions it aims to answer are:
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Efficacy of the specific stimulation protocol to increase anal pressures
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Tolerability and safety Participants will be exposed to the stimulation with the changes in pressure will be studied using high resolution anorectal manometry
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Single arm All participant will be exposed to the full stimulation protocol 2 different protocols using 2 different electrode arrays will be studied in random order. |
Device: Transcutaneous neuromuscular electrical stimulation
Transcutaneous electrical stimulation will be delivered to the anal sphincter and anal resting and squeezing pressures as a result of the stimulation will be recorded for different stimulation protocols using approved electrotherapy units
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Outcome Measures
Primary Outcome Measures
- Stimulation intensity levels [During exposure to electrical stimulation 5 min]
The stimulation intensity levels measured in milliamperes (mA) required to induce changes in anal sphincter pressures measured by manometry.
Secondary Outcome Measures
- Maximal tolerability to neuromuscular transcutaneous stimulation measured as the current in mA causing discomfort of at least 7 on a scale of 0 to 10 points. [During exposure to electrical stimulation 5 min]
The stimulation intensity levels measured as the current in milliamperes (mA) causing a discomfort level of 7 out of 10 point or the current at which a participant asks to stop the stimulation.
- Safety of neuromuscular transcutaneous stimulation measured as the proportion of patients reporting or presenting with adverse events during the study attributed or not to the use of electrical stimulation [Until discharge, assessed up to 7 days]
The Rate of Adverse Events (e.g., pain, skin reactions, prolonged abnormal sensation after stopping the stimulation, etc.) during the study attributed or not to the use of electrical stimulation
Eligibility Criteria
Criteria
Inclusion Criteria:
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Undergoing anorectal manometry for the evaluation of fecal incontinence indication
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Provision of signed and dated informed consent form
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Stated willingness to comply with all study procedures and availability for the duration of the study
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18 years old
Exclusion Criteria:
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Pregnant or attempting to become pregnant. The safety of electronic muscle stimulators during pregnancy has not been established.
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An electronic implant (e.g. cardiac pacemaker, implanted defibrillator) or suffer from heart problems.
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Conductive intra-uterine devices (IUD/Coil) or metal implants in the abdominal or pelvic area, including the hip and lumbar spine
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Cancer, epilepsy, or cognitive dysfunction.
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Pelvic floor surgery within the last six weeks.
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Complete denervation of the pelvic floor.
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Advanced full thickness rectal prolapse.
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Injured, inflamed or any significant disease in the peri-anal skin.
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Allergy to any component of the device, either known of developed during testing.
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Moderate to severe proctitis of any etiology.
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Skin irritation at the site of the stimulating electrodes
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Digestive Diseases Institute, Shaare Zedek Medical Center | Jerusalem | Israel | 90301 |
Sponsors and Collaborators
- Shaare Zedek Medical Center
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Livovsky DM, Koslowsky B, Goldin E, Lysy J. External kinesiology tape for improvement in fecal incontinence symptom bother in women: a pilot study. Int Urogynecol J. 2022 Oct;33(10):2859-2868. doi: 10.1007/s00192-021-05050-z. Epub 2022 Jan 18.
- Riedy LW, Chintam R, Walter JS. Use of a neuromuscular stimulator to increase anal sphincter pressure. Spinal Cord. 2000 Dec;38(12):724-7. doi: 10.1038/sj.sc.3101088.
- 0020-23-SZMC
- MOH_2023-04-16_012540