Use of biofeedback (BFB) in the treatment of fecal incontinence after surgical correction of anorectal malformations by posterior sagittal anorectoplasty (PSARP).
OBJECTIVE
To evaluate biofeedback (BFB) responses to rehabilitation techniques and physical exercises in incontinent or partially continent anorectal malformations patients after posterior sagital anorectoplasty (PSARP).


METHODS
Prospective study.


METHODS
Pediatric Surgery-Department of Surgery-UNIFESP-EPM.


METHODS
The authors report on 14 patients with anorectal malformations (4 with partial fecal incontinence after primary PSARP; 6 with fecal incontinence after primary PSARP; 3 with partial fecal incontinence after secondary PSARP; and 1 with fecal incontinence after secondary PSARP). All patients were rehabilitated via a BFB program of exercises in order to improve the function of the anal sphincteric muscular complex for a period of 1-3 years.


METHODS
Clinical and manometric control.


RESULTS
After BFB, of 4 partially continent patients after primary PSARP, 3 became continent; of 6 incontinent patients after primary PSARP, 4 became continent; of 3 partially continent patients after secondary PSARP, 1 became continent, 1 showed no improvement and 1 became incontinent (infection + abscess + fibrosis + important anorectal stenosis). The incontinent patient after secondary PSARP showed no improvement.


CONCLUSIONS
The authors concluded that BFB, used at the appropriate time with patient collaboration, is an important complement to the anatomical reconstruction of anorectal malformations in order to achieve good development and contractile functioning of the sphincteric muscular complex.
Martins
J L
JL
Department of Surgery, Federal University of São Paulo, EPM, Brazil.
Pinus
J
J
D000293:Adolescent; D000328:Adult; D001676:Biofeedback, Psychology; D002648:Child; D002675:Child, Preschool; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D011183:Postoperative Complications / Q000628:therapy*; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery