Tags

Type your tag names separated by a space and hit enter

Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence.
Dis Colon Rectum. 2002 Aug; 45(8):997-1003.DC

Abstract

PURPOSE

The aim of this study was to assess the long-term clinical and quality of life outcomes for patients after referral to a four-month treatment program for fecal incontinence based on pelvic floor exercises and biofeedback. Secondary objectives were to document patients' subsequent treatment activities and their perception of the biofeedback training; to establish the long-term outcomes and initial predictors for the subset of patients who did not complete the treatment, or who failed to improve during the program; and to correlate changes in clinical outcome measures and quality of life over time.

METHODS

Patients were contacted by telephone to determine their perception of progress subsequent to the treatment program, any subsequent treatment or activities relating to their fecal incontinence, and which aspect of the treatment program they believed was most helpful. St. Mark's and Pescatori fecal incontinence scores were also recorded, along with patients' self-assessments of their incontinence severity and quality of life.

RESULTS

Eighty-three (69 percent) patients were contacted for interviews at a median of 42 (range, 26-56) months after program completion. At the time of follow-up, patients who completed the program continued to enjoy strongly significant improvements in all outcome measures, with 75 percent perceiving a symptomatic improvement and 83 percent reporting improved quality of life. For many patients, improvement continued subsequent to program completion. Patients whose incontinence scores became worse during treatment still reported improvement in their quality of life and perceived incontinence severity during the same time period; many experienced some degree of "catch-up" in their continence scores during the follow-up period. Fourteen patients (17 percent) went on to have surgery for fecal incontinence; of these, 6 (7 percent) had a stoma. Twenty (24 percent) regularly took antidiarrheal medication. Thirty program completers (41 percent) were continuing pelvic floor exercises.

CONCLUSIONS

This study confirms the long-term improvement in fecal incontinence achieved through treatment with biofeedback and pelvic floor exercises. In this study, patients also continued to improve after treatment completion, possibly because of the strong emphasis placed on patients during treatment to continue the pelvic floor exercises on their own. The poor correlation between quality of life and quantitative scores of fecal incontinence suggests that there are important aspects of continence that are not being appropriately recognized.

Authors+Show Affiliations

Central Sydney Area Department of Colorectal Surgery at Royal Prince Alfred & Concord Hospitals, Sydney, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12195181

Citation

Pager, Chet K., et al. "Long-term Outcomes of Pelvic Floor Exercise and Biofeedback Treatment for Patients With Fecal Incontinence." Diseases of the Colon and Rectum, vol. 45, no. 8, 2002, pp. 997-1003.
Pager CK, Solomon MJ, Rex J, et al. Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence. Dis Colon Rectum. 2002;45(8):997-1003.
Pager, C. K., Solomon, M. J., Rex, J., & Roberts, R. A. (2002). Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence. Diseases of the Colon and Rectum, 45(8), 997-1003.
Pager CK, et al. Long-term Outcomes of Pelvic Floor Exercise and Biofeedback Treatment for Patients With Fecal Incontinence. Dis Colon Rectum. 2002;45(8):997-1003. PubMed PMID: 12195181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence. AU - Pager,Chet K, AU - Solomon,Michael J, AU - Rex,Jenny, AU - Roberts,Rachael A, PY - 2002/8/27/pubmed PY - 2002/9/28/medline PY - 2002/8/27/entrez SP - 997 EP - 1003 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 45 IS - 8 N2 - PURPOSE: The aim of this study was to assess the long-term clinical and quality of life outcomes for patients after referral to a four-month treatment program for fecal incontinence based on pelvic floor exercises and biofeedback. Secondary objectives were to document patients' subsequent treatment activities and their perception of the biofeedback training; to establish the long-term outcomes and initial predictors for the subset of patients who did not complete the treatment, or who failed to improve during the program; and to correlate changes in clinical outcome measures and quality of life over time. METHODS: Patients were contacted by telephone to determine their perception of progress subsequent to the treatment program, any subsequent treatment or activities relating to their fecal incontinence, and which aspect of the treatment program they believed was most helpful. St. Mark's and Pescatori fecal incontinence scores were also recorded, along with patients' self-assessments of their incontinence severity and quality of life. RESULTS: Eighty-three (69 percent) patients were contacted for interviews at a median of 42 (range, 26-56) months after program completion. At the time of follow-up, patients who completed the program continued to enjoy strongly significant improvements in all outcome measures, with 75 percent perceiving a symptomatic improvement and 83 percent reporting improved quality of life. For many patients, improvement continued subsequent to program completion. Patients whose incontinence scores became worse during treatment still reported improvement in their quality of life and perceived incontinence severity during the same time period; many experienced some degree of "catch-up" in their continence scores during the follow-up period. Fourteen patients (17 percent) went on to have surgery for fecal incontinence; of these, 6 (7 percent) had a stoma. Twenty (24 percent) regularly took antidiarrheal medication. Thirty program completers (41 percent) were continuing pelvic floor exercises. CONCLUSIONS: This study confirms the long-term improvement in fecal incontinence achieved through treatment with biofeedback and pelvic floor exercises. In this study, patients also continued to improve after treatment completion, possibly because of the strong emphasis placed on patients during treatment to continue the pelvic floor exercises on their own. The poor correlation between quality of life and quantitative scores of fecal incontinence suggests that there are important aspects of continence that are not being appropriately recognized. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/12195181/Long_term_outcomes_of_pelvic_floor_exercise_and_biofeedback_treatment_for_patients_with_fecal_incontinence_ L2 - http://link.springer.com/article/10.1007/s10350-004-6350-6 DB - PRIME DP - Unbound Medicine ER -