Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a
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REVIEW
Comparison of clinical and paraclinical characteristics of patients with urge, mixed, and passive fecal incontinence: a systematic literature review Charlotte Desprez 1,2 & N. Turmel 1 & C. Chesnel 1 & P. Mistry 1 & M. Tamiatto 1 & R. Haddad 1 & F. Le Breton 1 & A-M. Leroi 2 & C. Hentzen 1 & G. Amarenco 1 Accepted: 11 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Two subgroups of fecal incontinence (FI) are described in literature and used in clinical practice. However, the pertinence of this classification of FI is still unknown as there are no clear established guidelines. To a better understanding, we performed a systematic review to characterize the different types of FI (active, passive, or mixed) on the basis of clinical presentation and complementary explorations. Methods This systematic literature review was performed in reference to recommendations for systematic review using PRISMA guidelines without date restriction, until May 2020. This systematic review was performed without temporal limitation using MEDLINE-PubMed, Cochrane Library, and Google Scholar databases. Results Six hundred nine unique citations were identified from all the databases combined. Of those, 21 studies met the inclusion criteria, with 8 retrospective observational studies and 13 prospective observational studies. There was a lack of homogeneity in definitions of passive and urge (active) FI among studies. Prevalence of passive and urge FI was respectively of 4.0–5.0 and 15.0–35.0%. Clinical characteristics, physical examination, and endoanal imaging were not evaluated in most studies. In anorectal manometry, maximal squeeze pressure was higher in passive FI subgroup in most studies and results regarding maximal resting pressure remain discordant. There seemed to be no difference regarding first sensation volume and maximal tolerable volume among subgroups. A few studies evaluated pudendal terminal nerve motor latency with no difference among subgroups. Conclusion There is a lack of well-conducted prospective studies comparing the different subtypes of FI with validated definitions in both clinical and paraclinical examinations. Keywords Fecal incontinence . Active . Passive . Mixed . Systematic review
Introduction Guarantor of article Professor Gerard Amarenco * Charlotte Desprez [email protected] 1
GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, Sorbonne Université, 75020 Paris, France
2
Digestive physiology Unit, Rouen University Hospital, 1 rue de Germont, 76031 Rouen, France
Fecal incontinence (FI) is defined as the involuntary loss of feces by the International Continence Society [1], with the occurrence of more than 2 episodes of FI per month since at least 6 month of evolution of symptoms (Rome IV criteria) [2]. The estimated prevalence of FI varies from 2 to 21% [3] in the general population, leading to social isolation, impaired quality of life [4], and economic consequences [5]. Two subtypes of FI are commonly descri
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