Secca System for faecal incontinence

Introduction

Faecal incontinence (also described as bowel or anal incontinence) is the involuntary leakage of liquid or solid stool, mucus or gas. Some people get a sudden need to go to the toilet but are unable to reach it in time. This is known as urge incontinence (NHS Choices 2015). Others do not get this feeling before the leakage, which is known as passive incontinence. These 2 types can occur together or separately (Hull 2007). Faecal incontinence can have a serious effect on quality of life and often results in disability (Frascio et al. 2014). The incidence according to community-based studies ranges from 2% to 17% (Frascio et al. 2014), and it is more common in older people and women (NHS Choices 2015).

The severity of faecal incontinence can be assessed using scoring systems, such as the Vaizey faecal incontinence score, which may help guide treatment decisions. Treatments for faecal incontinence are conservative at first and include dietary changes, medication, muscle-strengthening exercises and biofeedback. If unsuccessful, minimally invasive and surgical options may be considered depending on the cause and severity of incontinence (Wang 2013).

Application of radiofrequency energy to the muscles of the anal canal is a minimally invasive treatment suggested for treating faecal incontinence. The aim of the procedure is to tighten the anal sphincter muscles, increasing the ability to recognise and retain stool, and reduce incontinence, as outlined in NICE's interventional procedure guidance on endoscopic radiofrequency therapy of the anal sphincter for faecal incontinence.