Electrical Treatment of Anal Incontinence and Rectal Prolapse Using an External Stimulator with Intra Anal Electrodes

Abstract

Parkes [1] showed that the normal pelvic floor is always in a state of electrical activity and tone. Phillips and Edwards [2] suggested that the activity of the pelvic floor is more important than anal sphincter tone in the mechanism of continence. Incontinent patients generally have very poor pelvic floor and sphincter tone, but Caldwell [3, 4, 5] Hopkinson [6, 7] and Lightwood [8] have described patients who have been made continent by electrical stimulation of the muscles involved. Caldwell implanted electrodes directly into the sphincter muscles and Hopkinson used an intra anal plug bearing two electrodes to stimulate the anal muscles. Some patients are made continent of urine as well as faeces by this treatment, presumably because of increased pelvic floor tone as demonstrated experimentally by Alexander and Rowan [9]. This paper describes further experience with the use of intra anal electrodes to treat patients with anal incontinence and rectal prolapse.