Fecal Incontinence Clinical Trial
Official title:
Prevalence and Treatment of Anal Incontinence in Primiparous Women
Traumatic tears of the sphincter ani muscles after delivery may result in symptomatic
urinary and anal incontinence, particularly in primiparas.
The efficacy of pelvic floor muscle exercise (PFME) in treating urinary incontinence is well
documented, however, to date there is little evidence to support the efficacy of PFME in
treating symptomatic anal incontinence.
This project consists of three separate studies. The prevalence survey/ study (1),
investigates the prevalence of symptomatic anal incontinence among primiparas at Ostfold
Hospital Trust Fredrikstad, Norway and St Olav's Hospital, Trondheim University Hospital,
Norway, and the results in this study will form the basis of the two identical randomized
controlled trials (RCT) investigating the treatment efficacy of PFME two groups of
postpartum women. Women reporting symptomatic anal incontinence at six months postpartum (2)
and women who have sustained a traumatic 3rd or 4th degree tear of the sphincter ani muscles
during delivery (3), respectively, are randomized to an intervention group receiving PFME
treatment for six months, or a control group. All RCT participants will undergo examination
of PFM strength and activity, as well as anal ultrasound prior to randomization and after
the intervention period.
The recruitment in RCT ( 2) has been lower than expected (49/72). Due to financial reasons and problems with logistics and preparations for the main hospital (Ostfold Hospital Trust) moving into a new hospital, we were unable to extend the recruitment period in study 1. In RCT (3) AI was not an inclusion criterion. However, as both RCTs had the same outcome measure; anal incontinence, and a joint randomization process, stratified on hospital site and whether the participants had sustained an obsteric anal sphincter injury at delivery or not, the results from these studies will be reported together. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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