Temperature-controlled radiofrequency energy in patients with anal incontinence: an interim analysis of worldwide data

Background: Controlled delivery of radiofrequency energy (SECCA procedure) as treatment for anal incontinence (AI) was introduced 15 years ago. Since then, several clinical studies have emerged. This article evaluates the clinical response and sustainability of SECCA for patients with AI. Methods: Only original clinical studies retrieved from PubMed and Medline were included. The outcome measures, faecal incontinence scores, definition of response, clinical results and anorectal evaluation were analysed. Results: Ten studies were included, which involved 150 original patients. Three studies reported a long-term follow-up. The one-year follow-up shows a moderate effect, which declines somewhat over time. Only minor temporary side-effects are reported and none of the patients declined treatment. Conclusion: SECCA is a safe and well-tolerated procedure that is easy to perform without any serious short- or long-term complications, but with only a moderate clinical effect that declines over time. Results of randomized, sham-controlled controlled trials are awaited.