Biofeedback is effective treatment for levator ani syndrome.
OBJECTIVE
The effects of biofeedback (BF) on pain relief and anorectal physiology in patients with levator ani syndrome (LAS) were prospectively studied.


METHODS
Sixteen consecutive patients (9 men, 7 women; mean age, 50.1 (range, 39-66) years) with LAS were treated with BF from July 1993 to October 1995. Mean duration of pain was 32.5 (standard error of the mean, 6.7) months. All underwent a full course of BF using a manometric balloon technique. Mean follow-up was 12.8 (standard error of the mean, 2.6) months. Pain score and anorectal physiology tests were administered prospectively by an independent observer before and after BF.


RESULTS
After BF, the pain score was significantly improved (before BF: median, 8 (range, 6-10); after BF: median, 2 (range, 1-4); P < 0.02). Analgesic requirements were also significantly reduced (all 16 patients needed nonsteroidal anti-inflammatory drugs (NSAID) before BF; only two patients needed NSAID after BF; P < 0.03). There were no significant changes to the anorectal physiology parameters after BF. To date, there have been no side effects or regressions.


CONCLUSIONS
Although BF had a negligible effect on anorectal physiologic measurements in LAS, it was effective in pain relief, with no side effects.
Heah
S M
SM
Department of Colorectal Surgery, Singapore General Hospital.
Ho
Y H
YH
Tan
M
M
Leong
A F
AF
D001003:Anal Canal / Q000503:physiopathology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001004:Anus Diseases / Q000503:physiopathology / Q000628:therapy*; D001676:Biofeedback, Psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D017773:Pelvic Floor / Q000503:physiopathology; D011446:Prospective Studies; D013577:Syndrome; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal