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Injectable bulking agents for treating faecal incontinence.

C J Vaizey¹, M A Kamm

¹Department of Physiology, St Mark's Hospital at Northwick Park, Watford Road, Harrow HA1 3UJ, UK. carolynne.vaizey@nwlh.nhs.uk <carolynne.vaizey@nwlh.nhs.uk>

The British Journal of Surgery

|April 27, 2005

Summary

Injectable bulking agents are increasingly used for fecal incontinence despite limited evidence. A wide product selection and undefined injection methods hinder robust clinical trials for this treatment.

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Area of Science:

Gastroenterology
Urology
Plastic Surgery

Background:

Injectable bulking agents for fecal incontinence are primarily supported by limited pilot studies.
Despite sparse data, their clinical application is rapidly expanding.
Bulking agents have a longer history in treating urinary incontinence.

Purpose of the Study:

To review available injectable bulking agents for fecal incontinence.
To summarize delivery methods based on existing literature and related surgical fields.

Main Methods:

Literature review of pilot studies on fecal incontinence bulking agents.
Inclusion of articles on agent use in urology, plastic surgery, and laryngology.
Consideration of relevant animal studies.

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Main Results:

A variety of bulking agent products are now available for fecal incontinence.
Experience from related surgical fields informs current practices.
Animal studies provide supplementary data.

Conclusions:

The use of bulking agents for fecal incontinence remains limited compared to urinary incontinence.
The proliferation of products and absence of standardized injection protocols present challenges.
Developing well-designed, prospective randomized trials for fecal incontinence treatment is hampered by current limitations.