***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : Numerous studies advocate the short-term benefits of sacral nerve stimulation for fecal incontinence , but there has been a paucity of studies on longer-term outcomes . OBJECTIVE : The objective of this study was to report the long-term outcome of sacral nerve stimulation performed for fecal incontinence at a single institution . PATIENTS AND DESIGN : Between January 2004 and May 2007 , 53 patients underwent definitive sacral nerve stimulation for fecal incontinence at our institution . Prospect ively recorded baseline information , including Wexner incontinence scores and st and ard short-form ( SF-12 ) health survey scores , were compared with scores at follow-up . RESULTS : Forty-one patients were available for long-term follow-up with a mean duration of 51 months . The median Wexner score decreased from a baseline of 11.5 ( range , 3.0–18.0 ) to 8.0 ( range , 0.0–18.0 ) at follow-up . The mean difference in Wexner score was 2.7 ( P < .001 ) . There was no statistically significant change in SF-12 physical scores , but a small but highly significant change occurred in SF-12 mental scores . The median SF-12 mental domain score was 49.5 ( range , 15.0–62.1 ) at baseline , and 57.0 ( range , 20.0–64.0 ) at follow-up , with a mean difference of 4.5 ( P = .006 ) . Subgroup analysis performed comparing patients with or without prior intersphincteric silicon bio material implants demonstrated a mean difference in Wexner score of −3.5 ( no implant ) vs 0.0 ( previous implant ) , with P < .09 ( not statistically significant ) . CONCLUSIONS : Sacral nerve stimulation results in a statistically significant improvement in fecal incontinence scores in the long term OBJECTIVES : Treatment of severe fecal incontinence ( FI ) is essentially surgical . However , patients in whom surgery has failed , those who have high operative risks , and those who refuse to undergo surgery are often condemned to living with this embarrassing condition . The Procon incontinence device , a relatively simple , nonsurgical device , may represent a good solution in preventing episodes of FI , thus improving quality of life in these individuals . This device consists of a disposable , pliable rubber catheter with an infrared photo-interrupter sensor and flatus vent holes on the distal tip that is connected to a pager ( or “ beeper ” ) . The catheter is inserted in the rectum and held in place by a 20-cc capacity cuff , which acts as a temporary mechanical barrier to stool leakage . Stool entering the rectum is sensed by the photo-interrupter sensor , which then alerts the patient to an imminent bowel movement . Voluntary evacuation is accomplished by deflating the balloon and removing the catheter . The aim of this study was to evaluate the efficacy , reliability , and safety of the Procon device in a group of patients with FI . METHODS : Patients with significant FI who had undergone anorectal manometry , ultrasound , and electromyography with pudendal nerve terminal motor latency assessment were prospect ively entered into this study . The Procon device was used for 14 consecutive days . A quality of life diary and daily log of bowel activity and incontinent episodes were completed before and after the end of the study . RESULTS : Seven patients ( five female and two male ) with a mean age of 72.7 yr ( range 39–81 yr ) were evaluated . Etiology of incontinence included idiopathic in four patients , sphincter defect in two , and neurological disorder in one patient . There was an overall significant improvement in the quality of life ( p < 0.05 ) and a significant reduction in incontinence scores with the Procon device ( p < 0.05 ) . CONCLUSION : The Procon is a unique , safe , and promising device that is able to prevent episodes of FI without the need for surgery , thereby improving quality of life . Its role includes use in patients with severe FI who are unfit to undergo surgery , those in whom previous surgical treatments have failed , or those who do not wish to undergo surgery BACKGROUND : Fecal incontinence is a debilitating ailment , and surgery offers the only recourse for the patients in whom conservative treatment fails . OBJECTIVE : This study aims to report the first matched comparison between patients implanted with the magnetic anal sphincter and the artificial bowel sphincter .  PATIENTS AND INTERVENTIONS : From December 2008 to June 2010 , 10 female patients , median age 64.5 years ( range , 42–76 ) , with severe fecal incontinence for a median of 7.5 years ( range , 1–40 ) , were implanted with the magnetic anal sphincter . Ten female patients implanted with the artificial bowel sphincter were identified . Both groups were matched for age , etiology , duration of incontinence , and preoperative functional scores . MAIN OUTCOME MEASURES : Outcomes measures included length of hospitalization , complications , and changes in functional scores ( anorectal physiology , incontinence , and quality of life ) . RESULTS : Patients with the magnetic anal sphincter had a shorter median operative time ( 62 vs 97.5 min , P = .0273 ) , length of hospitalization(4.5 vs 10 days , P < .001 ) , and follow-up duration ( 8 vs 22.5 mo , P = .0068 ) , without a statistically significant difference in 30-day complications ( 4 vs 2 , P = .628 ) and revision/explantation ( 1 vs 4 , P = .830 ) . Both groups achieved significant improvements in preoperative incontinence ( P < .0002 ) and quality -of-life scores ( P < .009 ) . In a comparison of baseline resting anal pressures , patients with the artificial bowel sphincter had significantly higher pressures with the cuff inflated ( P = .0082 ) , and those with the magnetic anal sphincter had a significant increase as well ( P = .0469 ) . At the latest review , both groups had similar quality -of-life scores ( P = .374 ) ; patients with the artificial bowel sphincter had higher ( median ) closed-cuff anal pressures compared with the anal resting pressure of those with a magnetic anal sphincter ( 89 vs 58.5 cmH2O , P = .0147 ) , together with more constipation ( 4 vs 1 , P = .830 ) and a trend toward better incontinence scores ( P = .0625 ) . LIMITATIONS : This was a nonr and omized study with small patient numbers . CONCLUSION : In the short term , the magnetic anal sphincter is as effective as the artificial bowel sphincter in restoring continence and quality of life BACKGROUND : Bowel dysfunction , including frequency , fecal urgency , stool consistency , and evacuation symptoms , contributes to fecal incontinence . OBJECTIVE : The purpose of this study was to examine the impact of a vaginal bowel control system on parameters of bowel function , including frequency , urgency , stool consistency , and evacuation . DESIGN : This was a secondary analysis of a multicenter , prospect i ve clinical trial . SETTING S : This study was conducted at 6 sites in the United States , including university hospitals and private practice s in urogynecology and colorectal surgery . PATIENTS : A total of 56 evaluable female subjects aged 19 to 75 years with 4 or more fecal incontinence episodes on a 2-week bowel diary were included . INTERVENTIONS : The study intervention was composed of the vaginal bowel control system , consisting of a vaginal insert and pressure-regulated pump . MAIN OUTCOME MEASURES : Subjects completed a 2-week baseline diary of bowel function before and after treatment completed at 1 month . Fecal urgency , consistency of stool ( Bristol score ) , and completeness of evacuation were recorded for all bowel movements . RESULTS : Use of the insert was associated with an improvement in bowel function across all 4 categories . Two thirds ( 8/12 ) of subjects with a high frequency of daily stools ( more than 2 per day ) shifted to a normal or low frequency of stools . Analysis of Bristol stool scale scores demonstrated a significant reduction in the proportion of all bowel movements reported as liquid ( Bristol 6 or 7 ) , from 36 % to 21 % ( p = 0.0001 ) . On average , 54 % of stools were associated with urgency at baseline compared with 26 % at 1 month ( p < 0.0001 ) . Incomplete evacuations with all bowel movements were reduced from 39 % to 26 % of subjects at 1 month ( p = 0.0034 ) . LIMITATIONS : The study follow-up period was 1 month ( with an optional additional 2 months ) . CONCLUSIONS : The vaginal bowel control system was associated with an improvement in bowel symptoms and function , including reduced bowel movement frequency , less fecal urgency , increased solid consistency , and improved evacuation in patients with significant fecal incontinence BACKGROUND Injection of a bulking agent in the anal canal is an increasingly used treatment for faecal incontinence , but efficacy has not been shown in a controlled trial . We aim ed to assess the efficacy of injection of dextranomer in stabilised hyaluronic acid ( NASHA Dx ) for treatment of faecal incontinence . METHODS In this r and omised , double-blind , sham-controlled trial , patients aged 18 - 75 years from centres in USA and Europe were r and omly assigned ( 2:1 ) to receive either transanal submucosal injections of NASHA Dx or sham injections . R and omisation was stratified by sex and region in blocks of six , and managed with a computer generated , real-time , web-based system . Patients and investigators were masked to assignment for 6 months when the effect on severity of faecal incontinence and quality of life was assessed with a 2-week diary and clinical assessment s. The primary endpoint was response to treatment based on the number of incontinence episodes . A response to treatment was defined as a reduction in number of episodes by 50 % or more . Patients in the active treatment group are still being followed up . This trial was registered with Clinical Trials.gov , number NCT00605826 . FINDINGS 278 patients were screened for inclusion , of whom 206 were r and omised assigned to receive NASHA Dx ( n=136 ) or sham treatment ( n=70 ) . 71 patients who received NASHA Dx ( 52 % ) had a 50 % or more reduction in the number of incontinence episode , compared with 22 patients who received sham treatment ( 31 % ; odds ratio 2·36 , 95 % CI 1·24 - 4·47 , p=0·0089 ) . We recorded 128 treatment-related adverse events , of which two were serious ( 1 rectal abscess and 1 prostatic abscess ) . INTERPRETATION Anal injection of NASHA Dx is an effective treatment for faecal incontinence . A refinement of selection criteria for patients , optimum injected dose , ideal site of injection , and long-term results might further increase the acceptance of this minimally invasive treatment . FUNDING Q-Med AB UNLABELLED 38 totally or partially incontinent patients following imperforate anus repair ( age 6 - 15 years ) tested a new polyurethane ( PU ) anal plug against another , widely used anal plug ( PVA ) in a r and omized crossover trial . Plugs were tested 3 weeks each , data concerning bowel habits , h and ling and plug-related problems were collected by question naire before trial , at time of product change and after trial . RESULTS 15 of 38 patients did not complete the protocol , among them 6 with anal canal diameters too small for the smallest plug . During plug use , patients experienced enhanced awareness of repletion and urge . Stool consistence did not change in 82 % of patients . There were no changes in children constipated prior to study ( n = 8/23 ) . 12,123 children were absolutely clean during use of either plug . 15 patients ( 68 % ) using the PU plug and 10 ( 45 % ) using the PVA plug  felt secure from soiling during plug use . 74 % of patients preferred the PU plug .  Painful plug insertion , a feeling of pressure inside the anal canal and painful plug removal were reported with both plugs , but were less frequent with the PU plug . CONCLUSION Anal plugs , regardless of their make , offer absolute cleanliness for periods of several hours to 66 % of our incontinent patients . The PU plug ( Conveen , Coloplast ) is preferred by the patients and offers greater security than the PVA plug BACKGROUND : Fecal incontinence is a socially stigmatized condition , and its prevalence in the community has been problematic to quantify because of difficulty with its definition . OBJECTIVE : This study estimates the community prevalence of fecal incontinence in New Zeal and by 3 scales of measurement : patient perceptions of a “ problem with bowel control , ” their symptoms , and their quality of life . DESIGN /MAIN OUTCOME MEASURES : A postal survey of 2000 people , aged > 18 , r and omly selected from the national electoral roll , was performed . This used a vali date d , reliability-tested , anonymous question naire , the Comprehensive Fecal Incontinence Question naire , incorporating the identification of a “ problem with bowel control , ” the Fecal Incontinence Severity Index , and the 
    Output:
    
Limited evidence indicates that both vaginal and anal inserts can be an effective and safe therapeutic option for patients with FI .
Conclusions : Data regarding vaginal and anal mechanical inserts for the treatment of FI , albeit limited , suggest that inserts can be included in a discussion of therapeutic options for a patient with FI .