Document Detail


Biofeedback therapy plus anal electrostimulation for fecal incontinence: prognostic factors and effects on anorectal physiology.
MedLine Citation:
PMID:  20108095     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The current literature does not provide unequivocal data on prognostic factors in conservative management of fecal incontinence. Moreover, the physiopathologic effects of pelvic floor rehabilitation on anorectal function are not well understood. Our aim is to identify some prognostic parameters and assess their effects on anorectal physiology of biofeedback therapy plus anal electrostimulation for fecal incontinence. METHODS: We studied prospectively 45 consecutive adult patients with fecal incontinence treated at our institution with biofeedback plus electrostimulation. The outcome parameter was modification of the Wexner Incontinence Score (WIS) at the end of treatment. In addition, we studied the modifications of anorectal manometry and the rectal sensitivity threshold after treatment. RESULTS: At univariate analysis, age, the pretreatment WIS, and the pretreatment resting and maximum squeeze pressures were correlated with the clinical outcome. Patients showed a significant reduction in the rectal sensitivity threshold but no significant change in manometric parameters after treatment. CONCLUSIONS: We identify good sphincter function and mild to moderate symptomatology as favorable prognostic factors in biofeedback and anal electrostimulation therapy. Improvement in rectal sensitivity can be implicated in symptomatic improvement. The impossibility of correlating the clinical results with the effects on anorectal physiology suggests a nonspecific effect of conservative treatment.
Authors:
Adamo Stefano Boselli; Ferdinando Pinna; Stefano Cecchini; Renato Costi; Federico Marchesi; Vincenzo Violi; Leopoldo Sarli; Luigi Roncoroni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  34     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  815-21     Citation Subset:  IM    
Affiliation:
Department of Surgical Sciences, Section of General Surgical Clinics and Surgical Therapy, Parma University Medical School, Via Gramsci 14, Parma, 43100, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anal Canal / physiopathology
Biofeedback, Psychology*
Chi-Square Distribution
Combined Modality Therapy
Electric Stimulation Therapy*
Electromyography
Endosonography
Fecal Incontinence / physiopathology,  psychology,  therapy*
Female
Humans
Male
Manometry
Middle Aged
Prognosis
Prospective Studies
Rectum / physiopathology
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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