Anorectal Disorders
Conditions
Keywords
Bidet, Sitz bath, Anal resting pressure
Brief summary
Sitz bath is conventional and empirical remedy and commonly recommended for non-operative treatment of various anal diseases. However, as there was no substitute for sitz bath until now, the patients have to accept the inconvenience for treatment of their diseases. Electronic bidet is used with convenience as automatic device for cleansing the perineal area, especially after defecation. The similarity of contacting water to perineal area, clinical use of electronic bidet has been suggested for treatment of anal diseases. However, there had been few reports of clinical use of electronic bidet. Investigators performed the study to evaluate the effects of electronic bidet on anal resting pressure, compared to conventional warm sitz bath in normal healthy volunteers.
Detailed description
Baseline Anorectal Manometry The Subjects underwent a digital rectal examination and baseline anorectal manometry in the lateral decubitus position using a device from Dynacompact (Menfis Biomedica Corp., Bologna, Italy) using an 8 channel polyvinyl (PVC) catheter with the measuring orifices oriented radially. Resting and maximal pressure in the anal canal were measured by pulling the catheter out of the anorectum at a speed of 0.5 mm/sec (the 'rapid pull through' technique) Recordings of Anal Resting Pressure on Electronic Bidet and Sitz Bath The subjects underwent clinical experiments for recordings of anal resting pressure changes using the electronic bidet and taking the sitz bath. For the measurement of effects of electronic bidet on anal resting pressure, a different manometry catheter (8 spirally arranged channels, 0.5 cm apart) was inserted into the anal canal placing the upper channels (channels No. 1-2) with a temperature probe in the rectum and the lower channels (channel No. 3-8) in the anal canal. The catheter was fixed in the buttock area using waterproof tape and subjects sat on a toilet equipped with an electronic bidet (Coway Corp, Seoul, Korea). After anal resting pressure had stabilized at the sitting position, anal resting pressure at high pressure zone (HPZ) was checked as control value to measure the change of anal resting pressure. The anal high pressure zone (HPZ) was defined as the channel representing the highest pressure within the anal canal for each subject. The pressures while sitting were adjusted for gravity. A water flow of the electronic bidet was applied to the anus for 3 minute. We designed the new water flow system of the electronic bidet, which was fountain type with very low force (10mN), as water falls down immediately after contacting the perineal area (Fig 1A). Before applying the water flow, mist type of water particles was sprayed for a few seconds for gentle contact with water first. The water used in the electronic bidet was a tap water of warm temperature about 38 degree celsius. Anal resting pressure at the channel of HPZ was checked at 1, 2 and 3 minutes after using the electronic bidet and percentage of anal resting pressure was calculated with compared to control value checked before using the electronic bidet. Maximum and minimum pressures in the HPZ during application of the electronic bidet were noted. Sitz bath was also undergone at another day. After insertion of catheter, the subjects were seated on a chair with small tub filled with warm water of about 38 degree celsius and sink their buttock (Fig 1B). The measurements of anal resting pressure were similar to the electronic bidet. Anal resting pressures of HPZ were checked before and after using the electronic bidet for 3 minutes. Maximum and minimum pressures were also checked.
Interventions
commercial electronic bidet
Conventional sitz bath
Sponsors
Study design
Eligibility
Inclusion criteria
* health volunteers
Exclusion criteria
* anorectal disorder * medical comorbidities * pregnancy * history of vaginal delivery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Anal Resting Pressure Change | 3 minute | before and after bidet/sitz bath for 3 minute |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Convenience | 3 minute | Questionnaires |
Countries
South Korea
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Electronic Bidet and Sitz Bath Electronic bidet for 3 minutes and sitz bath for 3 minutes, at another day, for each subject
Electronic bidet: commercial electronic bidet
Sitz bath: Conventional sitz bath | 40 |
| Total | 40 |
Baseline characteristics
| Characteristic | Electronic Bidet and Sitz Bath |
|---|---|
| Age, Continuous | 30.0 years |
| Region of Enrollment Korea, Republic of | 40 participants |
| Sex: Female, Male Female | 20 Participants |
| Sex: Female, Male Male | 20 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 40 |
| serious Total, serious adverse events | 0 / 40 |
Outcome results
Anal Resting Pressure Change
before and after bidet/sitz bath for 3 minute
Time frame: 3 minute
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Electronic Bidet and Sitz Bath | Anal Resting Pressure Change | Baseline Electronic bidet | 90.2 mmHg | Standard Deviation 24.6 |
| Electronic Bidet and Sitz Bath | Anal Resting Pressure Change | Post Electronic Bidet | 71.3 mmHg | Standard Deviation 23.4 |
| Electronic Bidet and Sitz Bath | Anal Resting Pressure Change | Baseline Sitz bath | 88.1 mmHg | Standard Deviation 16.8 |
| Electronic Bidet and Sitz Bath | Anal Resting Pressure Change | Post Sitz Bathbath | 69.6 mmHg | Standard Deviation 19.8 |
Convenience
Questionnaires
Time frame: 3 minute