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Safety and Efficacy of Permacol Injection in the Treatment of Fecal Incontinence
Yahya A Al-Abed1, Jennifer Ayers1, Abraham Ayantunde1
1Department of Colorectal Surgery, Southend University Hospital, Westcliff on Sea, United Kingdom.
Purpose:
Permacol has been gaining popularity in recent times for the treatment of fecal incontinence (FI). This study aims to evaluate the safety and efficacy of anal submucosal Permacol injection in the treatment of FI.
Methods:
All consecutive patients who underwent Permacol injection for FI over a 3-year period were included. Patients' data relating to obstetric history, anorectal/pelvic operations, type of FI, preoperative anorectal physiology results and follow-up details for outcome measures were collected. Preoperative and postoperative Cleveland Clinic Florida Incontinence Scores (CCFISs) were noted. Patients were surveyed by using a telephone questionnaire to assess the quality of life and other outcome measures. Data were analysed using SPSS ver.19.0.
Results:
Thirty patients (28 females and 2 males) with a median age of 67 years were included in the study. Of those patients, 37%, 50%, and 13% were noted to have passive, mixed and urge FI, respectively. Six of the patients (20%) had repeat Permacol injections, 5 of whom had sustained responses to the first Permacol injection for a mean of 11 months. There was a significant improvement in the CCFIS from a baseline median of 12.5, mean 12.8 interquartile range [IQR], 6-20), to a median of 3.5, mean 4.8 (IQR, 0-20), P < 0.001. Of the patients surveyed by telephone 89% were satisfied with their overall experience and the improvement in their symptoms following Permacol injections.
Conclusion:
This study has demonstrated that Permacol injection for the treatment of FI is safe and effective and has no associated major complications. However, the results are not permanent; consequently, a significant proportion of the patients with an initial response may require repeat injections.
Insights
Permacol injections offer a safe and effective treatment for fecal incontinence (FI), significantly improving patient quality of life. While initial results are promising, repeat injections may be necessary for sustained symptom relief.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Device Technology
Background:
- Fecal incontinence (FI) significantly impacts quality of life.
- Permacol injection is an emerging treatment option for FI.
- Evaluating novel therapeutic approaches for FI is crucial.
Purpose of the Study:
- To assess the safety and efficacy of anal submucosal Permacol injection for treating fecal incontinence.
- To determine the long-term outcomes and patient satisfaction following Permacol injection therapy.
Main Methods:
- A retrospective study included patients undergoing Permacol injection for FI over three years.
- Data collected included patient demographics, FI type, anorectal physiology, and follow-up outcomes.
- Cleveland Clinic Florida Incontinence Scores (CCFIS) and telephone surveys were used to evaluate efficacy and quality of life.
Main Results:
- Thirty patients (28 female, 2 male; median age 67) with various FI types were included.
- Significant improvement in CCFIS (P < 0.001) was observed post-injection.
- 89% of surveyed patients reported satisfaction with symptom improvement and overall experience.
Conclusions:
- Permacol injection is a safe and effective treatment for fecal incontinence with no major complications.
- While initial responses are positive, the effects may not be permanent, necessitating repeat injections in some patients.
- Permacol offers a viable option for managing fecal incontinence, improving patient outcomes and satisfaction.
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