Be Kind to Your Behind: A Systematic Review of the Habitual Use of Bidets in Benign Perianal Disease

Table 1

Characteristics and design of each study.

Study	Study type	N	Methodology	Intervention	Comparator	Outcomes measured
Kiuchi et al. [14]	Prospective cohort	7,637	Web-based survey with 1-year follow-up	Habitual users of bidet (at least once/day)	Non-habitual users (used less than once/week)	Odds of developing hemorrhoids, symptoms of hemorrhoids, and pruritus
Asakura et al. [15]	Prospective cohort	7,637	Web-based survey with 3-year follow-up	Habitual users of bidet (at least once/day)	Non-habitual users (used less than once/week)	Odds of developing hemorrhoids, symptoms of hemorrhoids, and pruritus
Tsunoda et al. [16]	Cross-sectional survey	4,963	Web-based survey	Use of bidet twice or more a day	Use of bidet once/day or less	16 questions related to bidet use and perianal symptoms (Table 3, multivariate analyses of pruritus ani with bidet use)
Kwon et al. [13]	Randomized controlled trial	74	Post-hemorrhoidectomy patients were instructed to use a bidet or sitz bath for 4 weeks	Bidet use (at least once/day)	Conventional sitz bath	Pain (measured on a visual analog score)
Garg [17]	Case series	10	Patients presented with anterior fissures after bidet use	Discontinuation of bidet use	None	Resolution of fissure with discontinuation of bidet use
Shulman et al. [18]	Case report	1	3rd degree burn caused by use of a bidet in a patient with multiple sclerosis	Bidet use	None	Burn symptoms caused by bidet use