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Prospective trial of pelvic floor retraining in patients with fecal incontinence.
Dis Colon Rectum. 1997 Jul; 40(7):821-6.DC

Abstract

PURPOSE

Our aim was to prospectively evaluate pelvic floor retraining (PFR) in improving symptomatic fecal incontinence.

METHODS

PFR was used to treat 30 patients with fecal incontinence (28 women; age range, 29-85 (median, 68) years). PFR was performed by a physiotherapist in the outpatient department according to a strict protocol and included biofeedback using an anal plug electromyometer. Manometry (24 patients), pudendal nerve terminal motor latency (PNTML, 16 patients), and anal ultrasound (14 patients) were done before commencing therapy. Independent assessment of symptoms was done at the commencement of therapy, at 6 weeks, and at 6 and 12 months posttherapy.

RESULTS

Twenty patients (67 percent) had improved incontinence scores, with eight patients (27 percent) being completely or nearly free of symptoms. Of 28 patients followed up longer than six months, 14 achieved a 25 percent or greater improvement at six weeks, which was sustained in all cases. Fourteen had an initial improvement of less than 25 percent, with only four (29 percent) showing later improvement (P < 0.0001). There was no relationship between results of the therapy and patient age, initial severity of symptoms, etiology of incontinence, and results of anal manometry, PNTML, and anal ultrasound.

CONCLUSIONS

PFR is a physical therapy that should be considered as the initial treatment in patients with fecal incontinence. An improvement can be expected in up to 67 percent of patients. Initial good results can predict overall outcome.

Authors+Show Affiliations

Department of Surgery, Flinders Medical Centre, Bedford Park, South Australia.No 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

Language

eng

PubMed ID

9221860

Citation

Rieger, N A., et al. "Prospective Trial of Pelvic Floor Retraining in Patients With Fecal Incontinence." Diseases of the Colon and Rectum, vol. 40, no. 7, 1997, pp. 821-6.
Rieger NA, Wattchow DA, Sarre RG, et al. Prospective trial of pelvic floor retraining in patients with fecal incontinence. Dis Colon Rectum. 1997;40(7):821-6.
Rieger, N. A., Wattchow, D. A., Sarre, R. G., Cooper, S. J., Rich, C. A., Saccone, G. T., Schloithe, A. C., Toouli, J., & McCall, J. L. (1997). Prospective trial of pelvic floor retraining in patients with fecal incontinence. Diseases of the Colon and Rectum, 40(7), 821-6.
Rieger NA, et al. Prospective Trial of Pelvic Floor Retraining in Patients With Fecal Incontinence. Dis Colon Rectum. 1997;40(7):821-6. PubMed PMID: 9221860.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective trial of pelvic floor retraining in patients with fecal incontinence. AU - Rieger,N A, AU - Wattchow,D A, AU - Sarre,R G, AU - Cooper,S J, AU - Rich,C A, AU - Saccone,G T, AU - Schloithe,A C, AU - Toouli,J, AU - McCall,J L, PY - 1997/7/1/pubmed PY - 1997/7/1/medline PY - 1997/7/1/entrez SP - 821 EP - 6 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 40 IS - 7 N2 - PURPOSE: Our aim was to prospectively evaluate pelvic floor retraining (PFR) in improving symptomatic fecal incontinence. METHODS: PFR was used to treat 30 patients with fecal incontinence (28 women; age range, 29-85 (median, 68) years). PFR was performed by a physiotherapist in the outpatient department according to a strict protocol and included biofeedback using an anal plug electromyometer. Manometry (24 patients), pudendal nerve terminal motor latency (PNTML, 16 patients), and anal ultrasound (14 patients) were done before commencing therapy. Independent assessment of symptoms was done at the commencement of therapy, at 6 weeks, and at 6 and 12 months posttherapy. RESULTS: Twenty patients (67 percent) had improved incontinence scores, with eight patients (27 percent) being completely or nearly free of symptoms. Of 28 patients followed up longer than six months, 14 achieved a 25 percent or greater improvement at six weeks, which was sustained in all cases. Fourteen had an initial improvement of less than 25 percent, with only four (29 percent) showing later improvement (P < 0.0001). There was no relationship between results of the therapy and patient age, initial severity of symptoms, etiology of incontinence, and results of anal manometry, PNTML, and anal ultrasound. CONCLUSIONS: PFR is a physical therapy that should be considered as the initial treatment in patients with fecal incontinence. An improvement can be expected in up to 67 percent of patients. Initial good results can predict overall outcome. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/9221860/Prospective_trial_of_pelvic_floor_retraining_in_patients_with_fecal_incontinence_ L2 - http://link.springer.com/article/10.1007/BF02055440 DB - PRIME DP - Unbound Medicine ER -