NCT07099339

Brief Summary

This randomized controlled clinical trial aims to evaluate the effect of pudendal nerve electrical stimulation on fecal incontinence in children with repaired anorectal malformation. Ithe investigators are hypothesized that PNES will significantly improve continence scores, reduce the frequency of fecal incontinent episodes, and enhance the overall quality of life in this vulnerable pediatric population, thereby addressing a critical unmet need in their long-term care. Children with repaired anorectal malformation may benefit more from combined pudendal nerve electrical stimulation with behavioral therapy and pelvic floor muscles training in improving fecal incontinence.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
18

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Nov 2024

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

November 2, 2024

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 20, 2025

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 3, 2025

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

July 25, 2025

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 1, 2025

Completed
Last Updated

August 17, 2025

Status Verified

August 1, 2025

Enrollment Period

5 months

First QC Date

July 25, 2025

Last Update Submit

August 13, 2025

Conditions

Keywords

Pudendal Nerve Electrical StimulationFecal IncontinenceChildrenRepairedAnorectal Malformation

Outcome Measures

Primary Outcomes (1)

  • Anal Sphincter Muscles Activity Peak

    Anal Sphincter Muscle Activity Peak was evaluated using anal pressure sensor (in mmHg) = anal squeeze pressure during maximum voluntary contraction - resting anal pressure at rest or resting tone as baseline activity.

    Baseline and after three months

Secondary Outcomes (2)

  • Defecation Frequency

    Baseline and after three months

  • Fecal Leakage Episodes

    Baseline and after three months

Study Arms (2)

Control Group

EXPERIMENTAL

Control Group children treated by Behavioral Therapy and Kegel Exercise, evaluated by assessing Anal Sphincter Muscle Activity Peak by anal pressure sensor and tracking Defecation Frequency and Fecal Leakage Episodes from the bowel diary.

Behavioral: Behavioral TherapyOther: Kegel ExerciseDiagnostic Test: Anal Sphincter Muscle Activity PeakDiagnostic Test: Bowel Diary Documentation

Study Group

EXPERIMENTAL

Study Group children treated by Behavioral Therapy, Kegel Exercise, and Pudendal Nerve Electrical Stimulation, evaluated by assessing Anal Sphincter Muscle Activity Peak by anal pressure sensor and tracking Defecation Frequency and Fecal Leakage Episodes from the bowel diary.

Behavioral: Behavioral TherapyOther: Kegel ExerciseDevice: Pudendal Nerve Electrical StimulationDiagnostic Test: Anal Sphincter Muscle Activity PeakDiagnostic Test: Bowel Diary Documentation

Interventions

Behavioral Therapy in form of: Learning and advices, Dietary modifications, Toilet pattern modification, Motivational rewarding system, and Diary documentation.

Also known as: Cognitive-Behavioral Therapy, Behavioral Modifications
Control GroupStudy Group

Kegel Exercise done by contracting and relaxing pelvic floor muscles for seconds with hold and repetitions.

Also known as: Pelvic Floor Muscles Training
Control GroupStudy Group

Pudendal Nerve Electrical Stimulation applied bilateral to the right and left pudendal by inserting rectal stimulator electrode anally with the other surface electrode at sacral region.

Also known as: Anal Electrical Stimulation, Anorectal Electrical Stimulation, Intra-anal Electrical Stimulation
Study Group

Anal Sphincter Muscle Activity Peak was evaluated using anal pressure sensor (in mmHg) = anal squeeze pressure during maximum voluntary contraction - resting anal pressure at rest or resting tone as baseline activity

Also known as: Pelvic Floor Muscles Activity, Anorectal Manometer
Control GroupStudy Group

Defecation Frequency and Fecal Leakage Episodes collected from the Bowel Diary that documenting bowel events daily through a period of time "a week".

Control GroupStudy Group

Eligibility Criteria

Age6 Years - 9 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • children ages ranged from 6 to 9 years and complain of involuntary leakage of feces with a history of anorectal surgical repair MRI revealed the degree of muscle development "Fair/Hypoplastic" identifiable but less developed or asymmetrical muscles
  • they can do minimal palpable voluntary contraction of anal sphincter muscle
  • they were able to follow instructions during the testing and treatment procedures.

You may not qualify if:

  • with severe hypoplasia or complete agenesis/absence of parts of the sphincter complex "Poor/Barely Identifiable/Absent", evidenced by MRI,
  • children with post-colon surgery other than ARM, neurologic/neuropathic disorder, spinal cord lesion, sensory or hearing deficits.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

General Organization for Teaching Hospitals and Institutes

Cairo, Cairo Governorate, 11562, Egypt

Location

MeSH Terms

Conditions

Fecal IncontinenceAnorectal Malformations

Interventions

Behavior TherapyCognitive Behavioral Therapy

Condition Hierarchy (Ancestors)

Rectal DiseasesIntestinal DiseasesGastrointestinal DiseasesDigestive System DiseasesDigestive System AbnormalitiesCongenital AbnormalitiesCongenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

PsychotherapyBehavioral Disciplines and Activities

Study Officials

  • GOTHI

    National Institute for Teaching Hospitals and Institutes

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
the assessor didn't know the grouping of children, intervention received, the data of first assessment.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized Controlled Clinical Trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
lecturer

Study Record Dates

First Submitted

July 25, 2025

First Posted

August 1, 2025

Study Start

November 2, 2024

Primary Completion

March 20, 2025

Study Completion

June 3, 2025

Last Updated

August 17, 2025

Record last verified: 2025-08

Locations