Recently, promising results with different modifications of an anal co
ntinence plug were reported in a pilot study. We have performed a clin
ical assessment of the plug preferred by the majority of patients in t
his study in an ambulatory group of patients incontinent to liquid and
solid stool. Nine of 14 patients (64 percent; 95 percent confidence i
nterval: 35-87 percent) were continent when they used the plug. In 43
percent (18-71 percent), the plug occasionally slipped out, and 71 per
cent (42-92 percent) experienced discomfort to a varying degree, which
caused 11 patients to withdraw from the study before the end of the p
lanned study period. No correlation was found between the results of a
norectal physiology studies and the benefit or inconvenience of using
the plug. The overall conclusion is that the majority of patients woul
d use the plug under special circumstances because it eliminates the f
ear of fecal leakage but that local discomfort, possibly due to the ma
terial, would prevent its daily use.