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Pelvic floor dyssynergia: efficacy of biofeedback training.
Arab J Gastroenterol 2011; 12(1):15-9AJ

Abstract

BACKGROUND AND STUDY AIMS

Paradoxical contraction of the pelvic floor during attempts to defaecate is described as pelvic floor dyssynergia (anismus). It is a behavioural disorder (no associated morphological or neurological abnormalities); consequently, biofeedback training has been recommended as a behavioural therapy for such a disorder. The aim of the present study was to evaluate long-term satisfaction of patients diagnosed with pelvic floor dyssynergia after biofeedback.

PATIENTS AND METHODS

Sixty patients (35 females and 25 males) with a mean age of 30±12years and a 4year duration of constipation were included. Forty-five patients had normal colonic transit and 15 patients had slow colonic transit. History, physical examination and barium enema were done to exclude constipation secondary to organic causes. Colonic and pelvic floor functions (colon-transit time, anorectal manometry, EMG and defaecography) were performed before and after biofeedback treatments. Patients were treated on a weekly basis with an average of (6±2) sessions.

RESULTS

At the end of sessions, 55 out of 60 patients (91.6%) reported a subjectively overall improvement. Symptoms of dyschezia were reported less frequently after biofeedback. Age and gender were not predictive factors of outcome. No symptoms at initial assessment were predictive for patient's satisfaction but the only factor of predictive value was the diagnosis of anismus and the motivated patient who wanted to continue the sessions.

CONCLUSION

Biofeedback remains a morbidity free, low-cost and effective outpatient therapy for well-motivated patients complaining of functional constipation and diagnosed as pelvic floor dyssynergia.

Authors+Show Affiliations

Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt. gadelhak_n_eg@hotmail.comNo 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)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21429449

Citation

Gadel Hak, Nabil, et al. "Pelvic Floor Dyssynergia: Efficacy of Biofeedback Training." Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology, vol. 12, no. 1, 2011, pp. 15-9.
Gadel Hak N, El-Hemaly M, Hamdy E, et al. Pelvic floor dyssynergia: efficacy of biofeedback training. Arab J Gastroenterol. 2011;12(1):15-9.
Gadel Hak, N., El-Hemaly, M., Hamdy, E., El-Raouf, A. A., Atef, E., Salah, T., ... Hamed, H. (2011). Pelvic floor dyssynergia: efficacy of biofeedback training. Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology, 12(1), pp. 15-9. doi:10.1016/j.ajg.2011.01.001.
Gadel Hak N, et al. Pelvic Floor Dyssynergia: Efficacy of Biofeedback Training. Arab J Gastroenterol. 2011;12(1):15-9. PubMed PMID: 21429449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pelvic floor dyssynergia: efficacy of biofeedback training. AU - Gadel Hak,Nabil, AU - El-Hemaly,Mohamed, AU - Hamdy,Emad, AU - El-Raouf,Ahmed Abd, AU - Atef,Ehab, AU - Salah,Tarek, AU - El-Hanafy,Ehab, AU - Sultan,Ahmad, AU - Haleem,Magdy, AU - Hamed,Hala, Y1 - 2011/02/24/ PY - 2010/07/29/received PY - 2010/10/05/revised PY - 2010/10/30/accepted PY - 2011/3/25/entrez PY - 2011/3/25/pubmed PY - 2011/7/16/medline SP - 15 EP - 9 JF - Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology JO - Arab J Gastroenterol VL - 12 IS - 1 N2 - BACKGROUND AND STUDY AIMS: Paradoxical contraction of the pelvic floor during attempts to defaecate is described as pelvic floor dyssynergia (anismus). It is a behavioural disorder (no associated morphological or neurological abnormalities); consequently, biofeedback training has been recommended as a behavioural therapy for such a disorder. The aim of the present study was to evaluate long-term satisfaction of patients diagnosed with pelvic floor dyssynergia after biofeedback. PATIENTS AND METHODS: Sixty patients (35 females and 25 males) with a mean age of 30±12years and a 4year duration of constipation were included. Forty-five patients had normal colonic transit and 15 patients had slow colonic transit. History, physical examination and barium enema were done to exclude constipation secondary to organic causes. Colonic and pelvic floor functions (colon-transit time, anorectal manometry, EMG and defaecography) were performed before and after biofeedback treatments. Patients were treated on a weekly basis with an average of (6±2) sessions. RESULTS: At the end of sessions, 55 out of 60 patients (91.6%) reported a subjectively overall improvement. Symptoms of dyschezia were reported less frequently after biofeedback. Age and gender were not predictive factors of outcome. No symptoms at initial assessment were predictive for patient's satisfaction but the only factor of predictive value was the diagnosis of anismus and the motivated patient who wanted to continue the sessions. CONCLUSION: Biofeedback remains a morbidity free, low-cost and effective outpatient therapy for well-motivated patients complaining of functional constipation and diagnosed as pelvic floor dyssynergia. SN - 2090-2387 UR - https://www.unboundmedicine.com/medline/citation/21429449/Pelvic_floor_dyssynergia:_efficacy_of_biofeedback_training_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1687-1979(11)00003-7 DB - PRIME DP - Unbound Medicine ER -