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Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients.
Dis Colon Rectum. 2006 Aug; 49(8):1149-59.DC

Abstract

PURPOSE

Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies.

METHODS

A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings.

RESULTS

Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups.

CONCLUSIONS

Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation.

Authors+Show Affiliations

Department of Radiology, Academic Medical Center, G1-229, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. m.p.terra@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16773492

Citation

Terra, M P., et al. "Electrical Stimulation and Pelvic Floor Muscle Training With Biofeedback in Patients With Fecal Incontinence: a Cohort Study of 281 Patients." Diseases of the Colon and Rectum, vol. 49, no. 8, 2006, pp. 1149-59.
Terra MP, Dobben AC, Berghmans B, et al. Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients. Dis Colon Rectum. 2006;49(8):1149-59.
Terra, M. P., Dobben, A. C., Berghmans, B., Deutekom, M., Baeten, C. G., Janssen, L. W., Boeckxstaens, G. E., Engel, A. F., Felt-Bersma, R. J., Slors, J. F., Gerhards, M. F., Bijnen, A. B., Everhardt, E., Schouten, W. R., Bossuyt, P. M., & Stoker, J. (2006). Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients. Diseases of the Colon and Rectum, 49(8), 1149-59.
Terra MP, et al. Electrical Stimulation and Pelvic Floor Muscle Training With Biofeedback in Patients With Fecal Incontinence: a Cohort Study of 281 Patients. Dis Colon Rectum. 2006;49(8):1149-59. PubMed PMID: 16773492.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients. AU - Terra,M P, AU - Dobben,A C, AU - Berghmans,B, AU - Deutekom,M, AU - Baeten,C G M I, AU - Janssen,L W M, AU - Boeckxstaens,G E E, AU - Engel,A F, AU - Felt-Bersma,R J F, AU - Slors,J F M, AU - Gerhards,M F, AU - Bijnen,A B, AU - Everhardt,E, AU - Schouten,W R, AU - Bossuyt,P M M, AU - Stoker,J, PY - 2006/6/15/pubmed PY - 2006/9/29/medline PY - 2006/6/15/entrez SP - 1149 EP - 59 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 49 IS - 8 N2 - PURPOSE: Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies. METHODS: A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings. RESULTS: Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups. CONCLUSIONS: Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/16773492/Electrical_stimulation_and_pelvic_floor_muscle_training_with_biofeedback_in_patients_with_fecal_incontinence:_a_cohort_study_of_281_patients_ L2 - http://link.springer.com/article/10.1007/s10350-006-0569-3 DB - PRIME DP - Unbound Medicine ER -