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The use of Permacol® injections for the treatment of faecal incontinence

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Abstract

The aim of this study is to assess the safety and efficacy of Permacol® implant for the treatment of idiopathic faecal incontinence using a novel injection technique. Patients with idiopathic passive faecal incontinence were selected for trans-submucosal injection of Permacol® after assessment by anorectal physiology and endoanal ultrasonography. Clinical assessment and St. Mark’s Incontinence Score were used to evaluate efficacy before and at two time points (1 and 2 years) after treatment. Rockwood Score were also used to determine quality of life before and after treatment. The Friedman and Chi-square tests were used to compare continuous and categorical data, respectively. A p value of <0.05 was deemed significant. Thirty-eight patients (24 female), median age 66 years, were recruited. At maximum clinical follow-up (median of 9 months), response to Permacol® injections was categorised as excellent, good, fair and poor in 12, 5, 4 and 17 patients, respectively. St. Mark’s Score improved in 72 and 63 % of patients at 1 and 2 years, respectively. However, a smaller proportion of patients (39 and 27 %, respectively) achieved a 50 %, or more, improvement in Mark’s Score. All four domains of Rockwood Quality of Life Score improved on first and second year follow-up, however, only two domains, coping and embarrassment, were statistically significant. Permacol® injection improved symptoms by >50 % in 39 and 27 % of patients on short and medium-term follow-ups, respectively. The trans-submucosal technique for injection of Permacol® in this study was safe with no significant adverse outcomes.

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Conflict of interest

We confirm that the paper is not under review and has not been accepted for publication elsewhere. We also confirm that there was no personal interest or funding interest involved in this study.

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Authors and Affiliations

  1. Department of Colorectal Surgery, York Teaching Hospital, 1 Celtic Close, York, YO26 5QJ, UK

    Zeiad I. Hussain, Michael Lim, Haider Mussa, Kazim Abbas & Stevan Stojkovic

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  1. Zeiad I. Hussain
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  2. Michael Lim
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  3. Haider Mussa
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  4. Kazim Abbas
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  5. Stevan Stojkovic
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Correspondence to Zeiad I. Hussain.

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Hussain, Z.I., Lim, M., Mussa, H. et al. The use of Permacol® injections for the treatment of faecal incontinence. Updates Surg 64, 289–295 (2012). https://doi.org/10.1007/s13304-012-0176-x

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  • DOI: https://doi.org/10.1007/s13304-012-0176-x

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