Biofeedback therapy after perineal rectosigmoidectomy or J pouch procedure.
The aim of this study was to determine the outcome and to identify possible predictors of success for biofeedback therapy after perineal rectosigmoidectomy (PRS) or coloanal or ileoanal J pouch. A retrospective chart review of all patients with electromyography-based biofeedback therapy due to fecal incontinence after PRS or a J pouch procedure was undertaken. Follow-up was obtained by telephone survey. Fourteen patients (4 men and 10 women) were included in this study. In the 9 patients after PRS, the frequency of daily bowel movements was 3.6+/-2.8 preoperatively, 4.1+/-3.2 prebiofeedback, and 2.2+/-1.3 postbiofeedback (P<.05). The frequency of daily incontinent episodes was reduced from 2.4+/-2.2 preoperatively and 2.0+/-1.9 prebiofeedback to 0.26+/-0.3 postbiofeedback (P<.05). The incontinence scores decreased from 17+/-3.1 preoperatively to 16+/-2.1 prebiofeedback and to 8.2+/-5 postbiofeedback (P<.001). At a follow-up of 15.8+/-7.1 months, 5 patients after the J pouch had decreased daily bowel frequency from 6.6+/-4.2 prebiofeedback to 3.3+/-2 postbiofeedback and 3.1+/-2 at follow-up (P<.05). The frequency of daily incontinent episodes was reduced from 1.9+/-1.3 prebiofeedback to 0.9+/-0.7 postbiofeedback to 0.7+/-0.8 at follow-up (P<.05). The incontinence scores decreased from 13.4+/-2.7 prebiofeedback to 8.8+/-5.1 postbiofeedback to 6.8+/-5.5 at follow-up (P<0.05). In both groups, the postbiofeedback incontinence score correlated with the prebiofeedback incontinence score. Furthermore, there was no correlation between outcome and age, interval between surgery and biofeedback therapy, frequency of biofeedback sessions, or manometry results in either group. Biofeedback therapy is an effective option for patients with fecal incontinence after perineal rectosigmoidectomy or colonic or ileal J pouch.
Hwang
Yong Hee
YH
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Choi
Jeong Seok
JS
Nam
Young Soo
YS
Salum
Mara R
MR
Weiss
Eric G
EG
Nogueras
Juan J
JJ
Wexner
Steven D
SD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology / Q000379:methods*; D003082:Colectomy / Q000009:adverse effects*; D039021:Colonic Pouches / Q000009:adverse effects*; D004576:Electromyography / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome