Multimodal rehabilitation for faecal incontinence: experience of an Italian centre devoted to faecal disorder rehabilitation.
BACKGROUND
Sphincter exercises and biofeedback therapy have been used to treat faecal incontinence but results have been unpredictable and standards of treatment have not yet been established. The aim of this study was to retrospectively evaluate the effects of a new multimodal rehabilitation model on faecal incontinence.


METHODS
All of the rehabilitative procedures are guided by manometric data. Primary study outcome criteria were the determination of changes or deterioration in incontinence, failure to achieve full continence and/or presence of faecal urgency. The clinical outcome was designed according to the Jorge-Wexner incontinence score.


RESULTS
Between 1997 and 2001, one hundred forty-nine incontinent patients (85 F and 64 M; age range, 41-73 years; mean age, 60.6 years) underwent multimodal rehabilitation at our outpatient unit. The overall mean incontinence score had significantly improved after treatment ( p<0.001), and 58 patients (38.9%) were symptom free. No patient reported any deterioration in incontinence. Faecal urgency persisted in 23 patients (15.4%).


CONCLUSIONS
In conclusion, multimodal rehabilitation, using manometric study, can modify the incontinence score.
Pucciani
F
F
Coloproctology Unit of Careggi-Florence, Department of General Surgery, University of Florence, Viale Morgagni 85, I-50134, Florence, Italy. pucciani@unifi.it
Iozzi
L
L
Masi
A
A
Cianchi
F
F
Cortesini
C
C
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D001676:Biofeedback, Psychology; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012007:Rectum / Q000503:physiopathology; D012189:Retrospective Studies