Radiofrequency therapy may improve fecal incontinence. (Novel Adaptation of Antisnoring TX).

ST. LOUTS -- Targeted radiofrequency energy may have a vibrant future for treatment of fecal incontinence.

Two recent prospective studies have shown that radiofrequency energy using the Secca system reduces symptoms of fecal incontinence and improves patient quality of life, Dr. Wayne B. Tuckson said at the 12th International Pelvic Reconstructive and Vaginal Surgery Conference. "Basically you're microwaving the anus and cooking the internal anal sphincter muscle," explained Dr. Tuckson, a colorectal surgeon at the University of Louisville (Ky.).

The Secca system developed by Curon Medical Inc. consists of an anoscopic device with electrodes and a radiofrequency generator. It was approved earlier this year by the Food and Drug Administration for treatment of fecal incontinence.

The procedure is an adaptation of techniques already used for treatment of snoring, esophageal reflux, and joint capsule laxity. The radiofrequency energy at 465 kHz and 2-5 watts is delivered deep to the submucosa. Tissue temperature in the target zone reaches 85[degrees] C for 70 seconds. Meanwhile, the temperature at the mucosal surface remains low due to the device's irrigation feature.

The intense radiofrequency energy creates a submucosal scar. The result is a lengthening of the anal high-pressure zone, leading to increased resistance that probably explains the functional improvement, according to Dr. Tuckson, who disclaimed any financial interest in the device.

Based upon the favorable clinical experience and few complications to date, the surgeon predicted that ...