Pilot study of two new injectable bulking agents for the treatment of faecal incontinence

Colorectal Dis. 2008 Mar;10(3):268-72. doi: 10.1111/j.1463-1318.2007.01318.x. Epub 2007 Jul 26.


Objective: The use of injectable bulking agents for passive faecal incontinence appears to provide reasonable short-term results. However experience with different agents is limited. We report on the outcome of injections with new bulking agents.

Method: Each patient received injections of either Bulkamid (hydrogel cross-linked with polyacrylamide) or Permacol (porcine dermal collagen). Assessment included clinical evaluation, anorectal physiological testing, endoanal ultrasonography and questionnaires including the St Mark's Incontinence Score, one week bowel diary card, the Faecal Incontinence Quality of Life Scale and the Short Form-36 (SF-36) health survey. Follow up was at 6 weeks and 6 months, with a further telephone review at a median of 19 months (range 14-22).

Results: Ten patients (nine female), median age 68 years (range 45-79), were enrolled. St Mark's incontinence score (0 = best, 24 = worst) was 15 (range 11-24) at baseline, 12.5 (range 3-18) at 6 weeks and 14 (range 6-22) at 6 months. A 1-week bowel diary and SF-36 forms also showed temporary improvement but this was not sustained beyond 6 weeks.

Conclusion: Bulkamid and Permacol injections did not have a major effect on faecal incontinence.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins / administration & dosage*
  • Administration, Rectal
  • Aged
  • Biocompatible Materials / administration & dosage*
  • Collagen / administration & dosage*
  • Fecal Incontinence / diagnosis
  • Fecal Incontinence / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrogels / administration & dosage*
  • Injections
  • Male
  • Middle Aged
  • Pilot Projects
  • Probability
  • Prospective Studies
  • Quality of Life
  • Recovery of Function
  • Risk Assessment
  • Single-Blind Method
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome


  • Acrylic Resins
  • Biocompatible Materials
  • Bulkamid
  • Hydrogels
  • Permacol
  • Collagen