{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:28:16Z","timestamp":1767652096383,"version":"3.40.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,25]],"date-time":"2013-04-25T00:00:00Z","timestamp":1366848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009813","name":"Q-Med AB","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009813","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Randomized, controlled trials have demonstrated the efficacy and safety of injectable bulking agents for the treatment of faecal incontinence (<jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>), although the long\u2010term outcome has not been assessed. <jats:styled-content style=\"fixed-case\">NASHA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>x gel, a biocompatible, nonallergenic bulking agent consisting of nonanimal stabilized hyaluronic acid and dextranomer microspheres, has demonstrated efficacy and safety for up to 12\u00a0months after treatment. The objective of this study was to evaluate the long\u2010term efficacy and safety of <jats:styled-content style=\"fixed-case\">NASHA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>x, assessed 24\u00a0months after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This study was a 24\u2010month follow\u2010up assessment of patients treated with <jats:styled-content style=\"fixed-case\">NASHA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>x under open\u2010label conditions. Data on <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> episodes and quality of life measures were collected from diaries over the 28\u2010day period immediately preceding the 24\u2010month assessment. Adverse events were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010three of 115 patients completed the 24\u2010month follow\u2010up assessment. At 24\u00a0months, 62.7% of patients were considered responders and experienced a \u2265\u00a050% reduction in the total number of <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> episodes. The median number of <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> episodes declined by 68.8% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Episodes of both solid and liquid stool incontinence decreased. The mean number of incontinence\u2010free days increased from 14.6 at baseline to 21.7 at 24\u00a0months (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Incontinence scores and <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> quality of life scores also showed significant improvements. The most common adverse events (<jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s) were proctalgia (13.3%) and pyrexia (9.6%). The majority of <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>s were mild to moderate, self\u2010limited and resolved within 1\u00a0month of the injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">NASHA<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>x is safe, effective and durable over a 24\u2010month period with a majority of patients experiencing significant improvement in multiple symptoms associated with <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12155","type":"journal-article","created":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T20:14:04Z","timestamp":1359749644000},"page":"569-574","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Long\u2010term efficacy of dextranomer in stabilized hyaluronic acid (<scp>NASHA<\/scp>\/<scp>D<\/scp>x) for treatment of faecal incontinence"],"prefix":"10.1111","volume":"15","author":[{"given":"F.","family":"La Torre","sequence":"first","affiliation":[{"name":"Department of Colorectal and Pelvic Surgery 1st College of Medicine \u2018SAPIENZA\u2019 Rome University Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"de la Portilla","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Department of General Surgery Hospital Universitario Virgen del Roc\u00edo Seville Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,25]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"557","volume-title":"Fundamentals of Anorectal Surgery","author":"Oliveira L","year":"1998"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5694\/j.1326-5377.2002.tb04283.x","article-title":"Prevalence of faecal incontinence and associated risk factors: an underdiagnosed problem in the Australian community?","volume":"176","author":"Kalantar JS","year":"2002","journal-title":"Med J Aust"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1854.2004.00642.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-005-0249-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1001\/jama.1995.03530070057030","article-title":"Community\u2010based prevalence of anal incontinence","volume":"274","author":"Nelson R","year":"1995","journal-title":"J Am Med Assoc"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.4.480"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00341234"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00004031"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(03)00327-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234209"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02235567"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234638"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.3276"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2298\/ACI0202023R"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9170-7"},{"key":"e_1_2_7_17_1","first-page":"CD007959","article-title":"Perianal injectable bulking agents as treatment for faecal incontinence in adults (review)","volume":"5","author":"Maeda Y","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.4161\/jig.19952"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655999750016988"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000053013.49676.89"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62297-0"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/467136"},{"key":"e_1_2_7_23_1","first-page":"3043","article-title":"World Medical Association Declaration of Helsinki. 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