Skip to main content

Advertisement

SpringerLink
Log in

Effects and Mechanisms of Vaginal Electrical Stimulation on Rectal Tone and Anal Sphincter Pressure

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

This study was designed to evaluate the effect of vaginal electrical stimulation on rectal tone and compliance and anal sphincter pressure and to explore possible mechanisms involved in the effects of vaginal electrical stimulation on rectal tone in conscious dogs.

Methods

Seven dogs inserted with a probe with two ring electrodes were studied. The study included two experiments. The first experiment was composed of two series of sessions rectal tone and compliance; and anal sphincter pressure. Each series included three sessions: vaginal electrical stimulation with long pulses, vaginal electrical stimulation with trains of long pulses, and vaginal electrical stimulation with trains of short pulses. The second experiment was performed in two sessions: vaginal electrical stimulation with long pulses plus guanethidine, and vaginal electrical stimulation with trains of long pulses plus guanethidine. In each session, rectal tone was recorded.

Results

1) Vaginal electrical stimulation with long pulses or trains of long pulses but not trains of short pulses significantly decreased rectal tone and increased anal sphincter pressure. 2) None of the vaginal electrical stimulation methods altered rectal compliance. 3) The inhibitory effect of vaginal electrical stimulation on rectal tone was abolished by guanethidine.

Conclusions

Vaginal electrical stimulation with long pulses or trains of long pulses but not trains of short pulses reduces rectal tone and increases anal sphincter pressure. The inhibitory effect of vaginal electrical stimulation on rectal tone is mediated by the sympathetic pathway. These findings suggest that vaginal electrical stimulation may be a potential therapy for fecal incontinence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others

References

  1. Maslekar S, Gardiner A, Maklin C, Duthie G S. Investigation and treatment of fecal incontinence. Postgrad Med J 2006;82:363–71.

    Article  PubMed  CAS  Google Scholar 

  2. Whitehead WE, Wald A, Norton NJ. Treatment options for fecal incontinence. Dis Colon Rectum 2001;44:131–42.

    Article  PubMed  CAS  Google Scholar 

  3. Nelson R, Norton N, Cautley E, Furner S. Community-based prevalence of anal incontinence. JAMA 1995;274:559–61.

    Article  PubMed  CAS  Google Scholar 

  4. Johanson JF, Lafferty J. Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 1996;91:33–6.

    PubMed  CAS  Google Scholar 

  5. Perry S, Shaw C, McGrother C, et al. Prevalence of fecal incontinence in adults aged 40 years or more living in the community. Gut 2002;50:480–4.

    Article  PubMed  CAS  Google Scholar 

  6. Rao SS. Practice guidelines, diagnosis and management of fecal incontinence. Am J Gastroenterol 2004;99:1585–604.

    Article  PubMed  Google Scholar 

  7. Davis KJ, Kumar D, Poloniecki J. Adjuvant biofeedback following anal sphincter repair: a randomized study. Aliment Pharmacol Ther 2004;20:539–49.

    Article  PubMed  CAS  Google Scholar 

  8. Ozturk R, Niazi S, Stessman M, Rao SS. Long-term outcome and objective changes of anorectal function after biofeedback therapy for fecal incontinence. Aliment Pharmacol Ther 2004;20:667–74.

    Article  PubMed  CAS  Google Scholar 

  9. Deutekom M, Dobben A. Plugs for containing fecal incontinence. Cochrane Library. Issue 3. Chichester: Wiley, 2005.

    Google Scholar 

  10. Madoff RD. Surgical treatment option for fecal incontinence. Gastroenterology 2004;126(Suppl 1):S48–54.

    Article  PubMed  Google Scholar 

  11. Halverson AL, Hull TL. Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 2002;45:345–8.

    Article  PubMed  Google Scholar 

  12. Madoff RD, Rosen HR, Baeten CG, et al. Safety and efficacy of dynamic muscle plasty for anal incontinence: lessons from a prospective, multicenter trial. Gastroenterology 1999;116:549–56.

    Article  PubMed  CAS  Google Scholar 

  13. Baeten CG, Bailey HR, Bakka A, et al. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. Dis Colon Rectum 2000;43:743–51.

    Article  PubMed  CAS  Google Scholar 

  14. Wong WD, Congliosi SM, Spencer MP, et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum 2002;45:1139–53.

    Article  PubMed  Google Scholar 

  15. Devesa JM, Rey A, Hervas PL, et al. Artificial anal sphincter: complications and functional results of a large personal series. Dis Colon Rectum 2002;45:1154–63.

    Article  PubMed  Google Scholar 

  16. Ganio EG, Luc AR, Clerico G, Trompetto M. Sacral nerve stimulation for treatment of fecal incontinence. Dis Colon Rectum 2001;44:619–31.

    Article  PubMed  CAS  Google Scholar 

  17. Lin ZY, Chen JD. Advances in gastrointestinal electrical stimulation. Critical Rev Biomed Engineer 2002;30:419–58.

    Article  Google Scholar 

  18. Nie Y, Pasricha JP, Chen JD. Anal electrical stimulation with long pulses increases anal sphincter pressure in conscious dogs. Dis Colon Rectum 2006;49:383–91

    Article  PubMed  Google Scholar 

  19. Fritz E, Hammer J, Schmidt B, et al. Stimulation of the nitric oxide-guanosine 3’, 5’-cyclic monophosphate pathway by sildenafil: effect on rectal muscle tone, distensibility, and perception in health and in irritable bowel syndrome. Am J Gastroenterol 2003;98:2253–60.

    PubMed  CAS  Google Scholar 

  20. Malcolm A, Phillips SF, Camilleri M, Hanson RB. Pharmacological modulation of rectal tone alters perception of distention in humans. Am J Gastroenterol 1997;92:2073–9.

    PubMed  CAS  Google Scholar 

  21. Chiarioni G, Bassotti G, Stanganini S, et al. Sensory retraining is key to biofeedblack therapy for formed stool fecal incontinence. Am J Gastroenterol 2002;97:109–17.

    Article  PubMed  CAS  Google Scholar 

  22. Diamant NE, Kamm MA, Wald A, Whitehead WE. AGA technical review on anorectal testing techniques. Gastroenterology 1999;116:735–60.

    Article  PubMed  CAS  Google Scholar 

  23. Pescatori M, Pavesio R, Anastasio G, Daini S. Transanal electrostimulation for fecal incontinence: clinical, psychologic, and manometric prospective study. Dis Colon Rectum 1991;34:540–5.

    Article  PubMed  CAS  Google Scholar 

  24. Jost WH. Electrostimulation in fecal incontinence: relevance of the sphincter compound muscle action potential. Dis Colon Rectum 1998;41:590–2.

    Article  PubMed  CAS  Google Scholar 

  25. Riedy LW, Chintam R, Walter JS. Use of a neuromuscular stimulator to increase anal sphincter pressure. Spinal Cord 2000;38:724–7.

    Article  PubMed  CAS  Google Scholar 

  26. Scheuer M, Kuijpers HC, Bleijenberg G. Effect of electrostimulation on sphincter function in neurogenic fecal continence. Dis Colon Rectum 1994;37:590–4.

    Article  PubMed  CAS  Google Scholar 

  27. Glen ES. Effective and safe control of incontinence by the intra-anal plug electrode. Br J Surg 1971;58:249–52.

    Article  PubMed  CAS  Google Scholar 

  28. Palmer LS, Richards I, Kaplan WE. Transrectal electrostimulation therapy for neuropathic bowel dysfunction in children with myelomeningocele. J Urol 1997;157:1449–52.

    Article  PubMed  CAS  Google Scholar 

  29. Larpent JL, Cuer JC, Da Poigny M. Clinical and manometrical results of electrical stimulation in patients with anal continence. Coloproctology 1987;9:183–5.

    Google Scholar 

  30. Hosker G, Norton C, Brazzelli M. Electrical stimulation for fecal incontinence in adults. Cochrane Database of Systemic Reviews: DOI: 10.1002/14651858. CD001310 [January 24, 2000]. Available at http://www.cuchrane.org/reviews/index.htm. Accessed October 20, 2004

  31. Chen JD, Xu X, Zhang J, et al. Efficiency and efficacy of multi-channel gastric electrical stimulation. Neurogastroenterol Motil 2005;17:1–5.

    Article  Google Scholar 

  32. Song GQ, Hou XH, Yang B, et al. Efficacy and efficiency of gastric electrical stimulation with short pulses in the treatment of vasopressin-induced emetic responses in dogs. Neurogastroenterol Motil 2006;18:385–91.

    Article  PubMed  CAS  Google Scholar 

  33. Hocking MP, Vogel SB, Sninsky CA. Human gastric myoelectrical activity and gastric emptying following gastric surgery and with pacing. Gastroenterology 1992;103:1811–6.

    PubMed  CAS  Google Scholar 

  34. Lin ZY, McCallum RW, Schirmer BD, Chen JD. Effects of pacing parameters in the entrainment of gastric slow waves in patients with gastroparesis. Am J Physiol 1998;274:G186–91.

    PubMed  CAS  Google Scholar 

  35. Song GQ, Hou XH, Yang B, et al. Two-channel gastric electrical stimulation accelerates delayed gastric emptying induced by vasopressin. Dig Dis Sci 2005;50:662–8.

    Article  PubMed  CAS  Google Scholar 

  36. Xu XH, Zhu HB, Chen JD. Pyloric electrical stimulation reduces food intake by inhibiting gastric motility in dogs. Gastroenterology 2005;128:43–50.

    Article  PubMed  Google Scholar 

  37. Eagon JC, Kelly KA. Effect of electrical stimulation on gastric electrical activity, motility and emptying. Neurogastroenterol Motil 1995;7:39–45.

    PubMed  CAS  Google Scholar 

  38. Zhao XT, Wang L, Chen JD. Intestinal electrical stimulation inhibits antral motility via sympathetic pathway but not nitric oxide pathway in conscious dogs. Gastroenterology 2004;126(Suppl 2):S1473.

    Google Scholar 

  39. Fall M, Lindström S. Electrical stimulation: a physiologic approach to the treatment of urinary incontinence. Urol Clin North Am 1991;18:393–407.

    PubMed  CAS  Google Scholar 

  40. Sand PK, Richardson DA, Staskin DR, et al. Pelvic floor electrical stimulation in the treatment of genuine stress incontinence: a multicenter, placebo-controlled trial. Am J Obstet Gynecol 1995;173:72–9.

    Article  PubMed  CAS  Google Scholar 

  41. Smith JJ III. Intravaginal stimulation randomized trial. J Urol 1996;155:127–30.

    Article  PubMed  Google Scholar 

  42. Petrol PE. The female pelvic floor: function, dysfunction and management according to the integral theory. 2nd ed. Heidelberg: Springer, 2007;43–4

  43. Matsufuji H, Yokoyama J. Neural control of the internal anal sphincter motility. J Smooth Muscle Re 2003;39:11–20.

    Article  Google Scholar 

  44. Malcom A, Camilleri M. Colo-anal motor coordination is association with high-amplitude colonic contractions after pharmacological stimulation. Am J Gastroenterol 2000;95:715–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Veterans Research Foundation, VA Medical Center, Oklahoma City, Oklahoma, USA

    Geng-Qing Song M.D., Ph.D., Hongbing Zhu M.S. & Jiande D. Z. Chen Ph.D.

  2. Division of Gastroenterology, University of Texas Medical Branch at Galveston, Galveston, Texas, USA

    Jiande D. Z. Chen Ph.D.

Authors
  1. Geng-Qing Song M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hongbing Zhu M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiande D. Z. Chen Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jiande D. Z. Chen Ph.D..

About this article

Cite this article

Song, GQ., Zhu, H. & Chen, J.D.Z. Effects and Mechanisms of Vaginal Electrical Stimulation on Rectal Tone and Anal Sphincter Pressure. Dis Colon Rectum 50, 2104–2111 (2007). https://doi.org/10.1007/s10350-007-9020-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-9020-7

Key words

Search

Navigation