Useful parameters helping proctologists to identify patients with defaecatory disorders that may be treated with pelvic floor rehabilitation.
BACKGROUND
No studies have specifically reported on the use of a diagnostic tool based on physiatric assessment of constipated or incontinent patients


METHODS
Sixty-seven constipated and 37 incontinent patients were submitted to a standard protocol based on proctologic examination, clinico-physiatric assessment (puborectalis contraction, pubococcygeal test, perineal defence reflex, muscular synergies, postural examination) and instrumental evaluation (anorectal manometry, anal US and dynamic defaecography). Patients were offered pelvic floor rehabilitation (thoraco-abdominoperineal muscle coordination training, biofeedback, electrical stimulation and volumetric rehabilitation).


RESULTS
After rehabilitation treatment, decreases of Wexner constipation score (p=0.0001) and Pescatori incontinence score (p=0.0001) were observed.


CONCLUSIONS
This diagnostic protocol might improve the selection of patients with defaecatory disorders amenable for rehabilitation treatment.
Brusciano
L
L
First Division of General and Gastrointestinal Surgery, Second University of Naples, Naples, Italy. luigibrusciano@tin.it
Limongelli
P
P
del Genio
G
G
Sansone
S
S
Rossetti
G
G
Maffettone
V
V
Napoletano
V
V
Sagnelli
C
C
Amoroso
A
A
Russo
G
G
Pizza
F
F
Del Genio
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology; D002648:Child; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D016896:Treatment Outcome