Biofeedback therapy in rectal prolapse patients.
OBJECTIVE
The aim of the study was to evaluate the effect of perioperative biofeedback training on postoperative continence in patients with rectal prolapse.


METHODS
Thirty-six consecutive patients were operated on between 1987 and 1993. Twenty-nine could be traced for reexamination. Four were excluded because of a recurring prolapse. Anal manometry, assessment of rectoanal sensation, and surface electromyography were performed during the reexamination. From 1987 to 1991, no perioperative biofeedback training was given (Group 1, n = 14). Since the beginning of 1992, incontinent patients were given biofeedback training (Group 2, n = 11).


RESULTS
Continence scores improved in both study groups. Both study groups had equally low resting pressures compared with Group 3 (controls) (30.6 +/- 14.9 vs. 53.0 +/- 11.9 mmHg; P < 0.001). Anal resting pressure correlated with postoperative continence score, whereas contractile pressures did not (r = -0.5,P < 0.05, and r = -0.3, p = not significant, respectively).


CONCLUSIONS
Biofeedback therapy can improve the function of external sphincter; however, the most important reason for postoperative incontinence in rectal prolapse patients is low resting pressure that cannot be corrected by biofeedback therapy.
Hämäläinen
K J
KJ
Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.
Raivio
P
P
Antila
S
S
Palmu
A
A
Mecklin
J P
JP
D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods; D004576:Electromyography; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010353:Patient Education as Topic; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D011300:Preoperative Care; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*