Anal Resting Pressure After Bidet, Compared to Sitz Bath
Condition: Anorectal Disorders
MeSH terms: Rectal Diseases
Study type: Interventional
Phase: Early Phase 1

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.
    

Intervention name(s): Electronic bidet; Sitz bath
Intervention type(s): Device; Device
Intervention description(s): commercial electronic bidet; Conventional sitz bath
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Bidet, Sitz bath, Anal resting pressure