Displaying all 15 publications

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  1. Mohd Sidik S
    Malays J Med Sci, 2010 Apr;17(2):18-23.
    PMID: 22135533 MyJurnal
    Urinary incontinence is a common but poorly understood problem in the elderly population. The aim of this study was to determine the prevalence of urinary incontinence and its associated factors among the elderly in a community setting.
    Matched MeSH terms: Fecal Incontinence
  2. Zailani MH, Azmi MN, Deen KI
    Med J Malaysia, 2010 Mar;65(1):66-7.
    PMID: 21265253 MyJurnal
    Faecal incontinence is a debilitating chronic clinical condition which may affect the patient and care givers. Modality of treatment is based on severity of the symptoms as well as the anatomical defect itself, availability of resources and expertise. We describe a modified technique of dynamic graciloplasty as neoanal sphincter for the treatment severe faecal incontinence who has failed previous over lapping sphincteroplasty. In our modified version, instead of using implanted intramuscular electrodes and subcutaneous neurostimulator to provide continuous stimulation, the patient will undergo an external stimulation on the nerve of transplanted gracilis periodically and concurrent biofeedback therapy. We believe the technique is relatively easy to learn and very cost effective without any electrodes or neurostimulator related complications.
    Matched MeSH terms: Fecal Incontinence/surgery*
  3. Engkasan JP, Sudin SS
    J Rehabil Med, 2013 Feb;45(2):141-4.
    PMID: 23053003 DOI: 10.2340/16501977-1074
    To describe the bowel programmes utilized by individuals with spinal cord injury; and to determine the association between the outcome of the bowel programmes and various interventions to facilitate defecation.
    Matched MeSH terms: Fecal Incontinence/etiology; Fecal Incontinence/rehabilitation; Fecal Incontinence/therapy*
  4. Paka C, Kamisan Atan I, Rios R, Dietz HP
    Female Pelvic Med Reconstr Surg, 2016 10 27;23(4):238-243.
    PMID: 27782978 DOI: 10.1097/SPV.0000000000000350
    OBJECTIVE: The aim of this study was to investigate the association of the anatomic integrity of the external anal sphincter (EAS) detected on transperineal ultrasound (TPUS) with symptoms of anal incontinence (AI) as measured by St Mark's Incontinence Score (SMIS) and the visual analog scale (VAS).

    METHODS: This is an observational, cross-sectional analysis of 486 women who presented to a tertiary urogynecological center between May 2013 and August 2014. They underwent a standardized interview and an examination that involved 3-dimensional/4-dimensional TPUS. The SMIS and VAS were administered if they answered positively to a question on AI. The association between defects of the EAS and symptoms of AI was evaluated using bivariate tests, as well as adjusting for pertinent covariates using multiple linear regression modeling.

    RESULTS: Of the included patients, 17.1% reported AI, and 15.2% had significant EAS defects (≥4 slices) on TPUS imaging. A significant sonographic defect was diagnosed in 23% of women with AI versus 14% of those without (P = 0.033). Women with symptoms of AI were more likely to have a significant defect on TPUS (odds ratio, 1.878; 95% confidence interval, 1.05-3.37). No significant findings were seen when analyzing SMIS, its components, and VAS against sonographic EAS defects.

    CONCLUSIONS: The symptom of AI is associated with significant EAS defects detected on TPUS. However, this study failed to show an association between significant EAS defects and the SMIS and VAS.

    Matched MeSH terms: Fecal Incontinence/etiology*; Fecal Incontinence/physiopathology
  5. Paka C, Atan IK, Dietz HP
    Tech Coloproctol, 2016 Feb;20(2):123-8.
    PMID: 26573810 DOI: 10.1007/s10151-015-1397-z
    Patient self-report is important in the assessment of the impact of anal incontinence (AI) on quality of life. This study aimed to (1) determine the correlation between total St. Mark's Incontinence Score (SMIS) and a single-item visual analogue scale (VAS) for bother from AI, and (2) determine the correlation between individual components of SMIS and VAS.
    Matched MeSH terms: Fecal Incontinence/physiopathology; Fecal Incontinence/psychology*
  6. Soon LE
    Med J Malaysia, 1988 Dec;43(4):340-3.
    PMID: 3241599
    Matched MeSH terms: Fecal Incontinence
  7. Hussin P, Chan CY, Saw LB, Kwan MK
    Emerg Med J, 2009 Sep;26(9):677-8.
    PMID: 19700594 DOI: 10.1136/emj.2008.064972
    U-shaped sacral fracture is a very rare injury. This injury is easily missed and the diagnosis is often delayed as it is difficult to detect on the anteroposterior view of the pelvic radiograph. It is highly unstable and neurological injury is common. Two cases of U-shaped sacral fractures are reported here in which the diagnosis was delayed resulting in the late development of cauda equina syndrome. In these two cases, full recoveries were achieved following surgical decompression. A high index of suspicion with proper clinical and radiographic assessments will decrease the incidence of missed diagnosis and prevent the occurrence of delayed neurological deficits.
    Matched MeSH terms: Fecal Incontinence/etiology
  8. Oversand SH, Atan IK, Shek KL, Dietz HP
    Ultrasound Obstet Gynecol, 2016 May;47(5):642-5.
    PMID: 25989530 DOI: 10.1002/uog.14902
    OBJECTIVE: To assess the association between clinical and sonographic measures of pelvic floor muscle (PFM) function and symptoms of urinary and anal incontinence (AI).

    METHODS: This was a retrospective study of women seen at a tertiary urogynecological unit. All women had undergone a standardized interview, clinical examination including Modified Oxford Scale (MOS) grading, urodynamic testing and four-dimensional translabial ultrasound (TLUS). Cranioventral shift of the bladder neck (BN) and reduction in the hiatal anteroposterior (AP) diameter were measured using ultrasound volumes acquired on maximal PFM contraction, blinded against all clinical data.

    RESULTS: Data from 726 women with a mean age of 56 ± 13.7 (range, 18-88) years and a mean body mass index of 29 ± 6.1 (range, 17-55) kg/m(2) were analyzed. Stress (SI) and urge (UI) urinary incontinence were reported by 73% and 72%, respectively, and 13% had AI. Mean MOS grade was 2.4 ± 1.1 (range, 0-5). Mean cranioventral BN shift on TLUS was 7.1 ± 4.4 (range, 0.3-25.3) mm; mean reduction in AP hiatal diameter was 8.6 ± 4.8 (range, 0.3-31.3) mm. On univariate analysis, neither MOS nor TLUS measures were strongly associated with symptoms of urinary incontinence or AI; associations were non-significant except for BN displacement/SI (7.3 mm vs 6.5 mm; P = 0.028), BN displacement/UI (6.85 vs 7.75; P = 0.019), hiatal AP diameter/AI (9.6 mm vs 8.5 mm; P = 0.047) and MOS/SI (2.42 vs 2.19; P = 0.013).

    CONCLUSIONS: In this large retrospective study we did not find any strong associations between sonographic or palpatory measures of PFM function and symptoms of urinary incontinence or AI. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

    Matched MeSH terms: Fecal Incontinence/epidemiology*
  9. Kim M, Meurette G, Ragu R, Wyart V, Lehur PA
    Ann Surg, 2019 02;269(2):310-314.
    PMID: 28902668 DOI: 10.1097/SLA.0000000000002512
    OBJECTIVE: Magnetic anal sphincter augmentation is a novel surgical option in the treatment of severe fecal incontinence. This study aimed to analyze functional results, quality of life, and satisfaction after implantation in the mid-term, and to identify factors associated with success of this new treatment.

    METHODS: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included. Symptom severity [Cleveland Clinic Incontinence Score (CCIS)], quality of life [Fecal-Incontinence Quality of Life Questionnaire (FIQL)], bowel diary data, and patients' satisfaction were assessed before and after implantation.

    RESULTS: Forty-five patients (43 female), mean (s.d.) age 66.82 (±10.07), were followed for a median of 36 months (range 6-84). Two patients were explanted and 1 lost to follow-up. On a 3-week diary, major leakage rate significantly improved as did CCIS and FIQL. No significant difference was seen for flatus and minor leaks. Postoperative decrease of CCIS by ≥5.5 points correlated best with satisfaction, expressed by 22 patients (48% in intention-to-treat analysis). An independent predictive factor for success after implantation was no previous fecal incontinence surgical treatment.

    CONCLUSIONS: Satisfaction, functional, and quality of life outcomes improve significantly following magnetic anal sphincter augmentation.

    Matched MeSH terms: Fecal Incontinence/surgery*
  10. Roslani AC, Ramakrishnan R, Azmi S
    Med J Malaysia, 2017 12;72(6):333-337.
    PMID: 29308769 MyJurnal
    BACKGROUND: Faecal incontinence (FI) is not a common presenting complaint in Malaysia, and little has been published on this topic. Since it is a treatable condition, a greater understanding of factors contributing to healthseeking behaviour is needed in order to plan effective provision of services.

    METHODS: A survey of 1000 patients and accompanying relatives, visiting general surgical and obstetrics and gynaecology clinics for matters unrelated to FI, was conducted at University Malaya Medical Centre between January 2009 and February 2010. A follow-up regression analysis of the 83 patients who had FI, to identify factors associated with health-seeking behaviour, was performed. Variables identified through univariate analysis were subjected to multivariate analysis to determine independence. Reasons for not seeking treatment were also analysed.

    RESULTS: Only eight patients (9.6%) had sought medical treatment. On univariate analysis, the likelihood of seeking treatment was significantly higher among patients who had more severe symptoms (OR 30.0, p=0.002), had incontinence to liquid stool (OR 3.83, p=0.002) or when there was an alteration to lifestyle (OR: 17.34; p<0.001). Nevertheless, the only independently-associated variable was alteration in lifestyle. Common reasons given for not seeking treatment was that the condition did not affect patients' daily activities (88.0%), "social taboo" (5.3%) and "other" reasons (6.7%).

    CONCLUSIONS: Lifestyle alteration is the main driver of healthseeking behaviour in FI. However, the majority do not seek treatment. Greater public and physician-awareness on FI and available treatment options is needed.

    Matched MeSH terms: Fecal Incontinence*
  11. Guzmán Rojas RA, Kamisan Atan I, Shek KL, Dietz HP
    Ultrasound Obstet Gynecol, 2015 Sep;46(3):363-6.
    PMID: 25766889 DOI: 10.1002/uog.14845
    To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma.
    Matched MeSH terms: Fecal Incontinence/etiology*; Fecal Incontinence/ultrasonography
  12. Roslani AC, Ramakrishnan R, Azmi S, Arapoc DJ, Goh A
    BMC Gastroenterol, 2014;14:95.
    PMID: 24885285 DOI: 10.1186/1471-230X-14-95
    Prevalence data is essential for planning of healthcare services. The prevalence of faecal incontinence (FI) varies worldwide, and in Malaysia is not known. We sought to estimate its prevalence among patients with various conditions in a Malaysian academic setting.
    Matched MeSH terms: Fecal Incontinence/ethnology; Fecal Incontinence/epidemiology*
  13. Singh M, Sharma A, Duthie G, Balasingh D, Kandasamy P
    Asian J Surg, 2005 Jul;28(3):189-91.
    PMID: 16024313
    Treatment of anal fissures has changed dramatically in the past decade. This is primarily due to a better understanding of its pathophysiology and the implications of the various available options. Only a few anal fissures fail to respond to medical therapy. Sphincterotomy and anal dilatation have fallen out of favour due to the risk of incontinence. Island flaps have been proposed to address this, but 60-70% of the flap donor sites break down with complications. We propose using a rotation flap to overcome this problem.
    Matched MeSH terms: Fecal Incontinence/prevention & control
  14. Hutson JM, Hynes MC, Kearsey I, Yik YI, Veysey DM, Tudball CF, et al.
    Pediatr Surg Int, 2020 Jan;36(1):11-19.
    PMID: 31673760 DOI: 10.1007/s00383-019-04587-x
    Children with chronic idiopathic constipation (CIC) often end up at the surgeon when medical treatments have failed. This opinion piece discusses a recently described pattern of CIC called 'Rapid transit constipation (RTC)' first identified in 2011 as part of surgical workup. RTC was identified using a nuclear medicine gastrointestinal transit study (NMGIT or nuclear transit study) to determine the site of slowing within the bowel and to inform surgical treatment. Unexpectedly, we found that RTC occured in 29% of 1000 transit studies in a retrospective audit. Irritable bowel syndrome (IBS) occurs in 7-21% of the population, with a higher prevalence in young children and with constipation type dominating in the young. While 60% improve with time, 40% continue with symptoms. First-line therapy for IBS in adults is a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols which reduces symptoms in > 70% of patients. In children with functional gastrointestinal disorders, fructose intolerance occurs in 35-55%. Reducing fructose produced significant improvement in 77-82% of intolerant patients. In children with RTC and a positive breath test upon fructose challenge, we found that exclusion of fructose significantly improved constipation, abdominal pain, stool consistency and decreased laxative use. We hypothesise that positive breath tests and improvement of pain and bowel frequency with sugar exclusion diets in RTC suggest these children have IBS-C. These observations raise the possibility that many children with CIC could be treated by reducing fructose early in their diet and this might prevent the development of IBS in later life.
    Matched MeSH terms: Fecal Incontinence/etiology
  15. Hassan MZ, Rathnayaka MM, Deen KI
    World J Surg, 2010 Jul;34(7):1641-7.
    PMID: 20180122 DOI: 10.1007/s00268-010-0489-1
    We undertook a prospective longitudinal study of patients with end-stage fecal incontinence who were undergoing transposition of the gracilis muscle as a neo-anal sphincter with external low-frequency electrical stimulation of the nerve to the gracilis combined with biofeedback.
    Matched MeSH terms: Fecal Incontinence/surgery*
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