Use edit
Who uses anal plugs edit
Typically, anal tampons are used in patients whose symptoms do not improve with to typical treatments: this may include changes in diet, physical therapy, nerve stimulation targeting the sacral and tibial nerves, etc.[1] Children with certain conditions, including spina bifida and anal atresia, may struggle with leaks even after physical therapy and other interventions, so they may benefit from using anal plugs. [2][3] Elderly patients
The one common feature of people who use anal plugs is they all experience fecal incontinence.
"Inclusion criteria for all studies overlapped considerably with common denominators being FI to liquid and solid stool, idiopathic FI, ambulant self-caring patients and the absence of any ongoing low rectal or anal infammation. Comparable patient characteristics have been reported for more invasive and morbid procedures such as sacral nerve stimulation [20] and bulking agents [21]. Exclusion criteria were more numerous with the pump devices and in particular, the Eclipse system, suggesting a smaller group of patients that would beneft from this device" [1]
When is it used? Ever used for anything other than fecal incontinence?
What populations use it the most?
How does it work?
Frequency of changing tampons
"Mechanical insert devices work by providing a physical obstruction to the passage of stool and fatus. Vaginal inserts have a posteriorly directed balloon that provides controlled occlusion of the rectum. Anal inserts provide a direct physical barrier by occluding the lower rectum and anal canal. By doing this, it is hoped that episodes of incontinence can be prevented. They represent a potentially safe and costefective treatment for FI. However, little has been reported on the diferent types of available insert, their efectiveness in comparison to other treatments, long-term efcacy and impact on quality of life (QoL)." [1]
How does it work? edit
Different brands and designs work differently. All anal plugs work by physically blocking the anus, thereby preventing leaks. They can be worn for different amounts of times depending on the design of the plug: they can be safely worn for a maximum of 6-12 hours, depending on the brand.
can have in comfortably up to 12 hours
"the optimum plug (large tulip) had a median wear-time of 12 h and there were no episodes of incontinence in 82% of the time the plug was in place"[1]
"An average of 2.6 inserts was used per day"[1]
Why use it? aka who would benefit from use vs who is a poor candidate edit
" Subjective interview data reported the plug to confer better control, more regulated bowel movement and prevention of anal skin rashes and soreness. Reported disadvantages were difficulty with insertion, retention, leakage and discomfort"[1]
"Eighty percent of respondents ‘liked’ the inserts" [1] talk about how receptiveness has varied widely on a trial-by-trial basis?
" there is evidence to suggest both anal and vaginal insert devices may be of beneft to the majority of patients with FI" [1]
"The Renew device appears to be better tolerated because it is considerably smaller and is composed of soft silicone which is inserted with an applicator. Only the smallest (n=15) of the three Renew studies failed to show a statistically signifcant improvement in bowel control and QoL with the plug though there was a trend towards improvement"[1]
"However, hypersensitivity of the alarm system in patients with loose stool or mucous leakage appears to hinder its [the procon's] usefulness, even with the more recent ProTect device. Furthermore, it is hindered by the need for strong patient motivation and a degree of manual dexterity that may be challenging for some patients. Whilst the outcome data are too heterogenous to enable formal comparisons, it would appear that the anal pump devices do not confer a signifcant advantage over anal plugs, particularly the Renew device"[1]
Usage edit
When is it used? - ultimately for fecal incontinence. secondary conditions include colostomy plug, spina bifida patients, imperforate anus.
"3 variations of the Coloplast polyurethane sponge design, originally designed as a colostomy plug[1]" uses?
"It is presumed that both anal and vaginal insert devices are benefcial predominantly for those patients with passive incontinence and all but two of the studies focused on this patient group. Sharma et al. [18] demonstrated a reduction in urgency-related events with the Eclipse system whilst Lukasz et al. [12] included patients with urgency" [1]
Reference edit
- ^ a b c d e f g h i j k l How, P.; Trivedi, P. M.; Bearn, P. E.; Thomas, G. P. (2021-03-01). "Insert devices for faecal incontinence". Techniques in Coloproctology. 25 (3): 255–265. doi:10.1007/s10151-020-02317-3. ISSN 1128-045X.
- ^ Shoshan, Levana; Ben-Zvi, Dvora; Katz-Leurer, Michal (2008-10). "Use of the Anal Plug in the Treatment of Fecal Incontinence in Patients With Meningomyelocele". Journal of Pediatric Nursing. 23 (5): 395–399. doi:10.1016/j.pedn.2006.09.006.
{{cite journal}}: Check date values in:|date=(help) - ^ Van Winckel, M.; Van Biervliet, S.; Van Laecke, E.; Hoebeke, P. (2006-07). "Is an Anal Plug Useful in the Treatment of Fecal Incontinence in Children With Spina Bifida or Anal Atresia?". Journal of Urology. 176 (1): 342–344. doi:10.1016/S0022-5347(06)00302-8. ISSN 0022-5347.
{{cite journal}}: Check date values in:|date=(help)
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