title: Biofeedback vs. electrostimulation in the treatment of postdelivery anal incontinence: a randomized, clinical trial.
abstract: OBJECTIVE
  This study was designed to evaluate the effect of biofeedback and electrostimulation in a randomized, clinical trial for the treatment of patients with postdelivery anal incontinence.
  
  
  METHODS
  Forty-nine females who sustained third-degree or fourth-degree perineal rupture with a mean age of 36 (range, 22-44) years were included in the study. The females were randomized to biofeedback or electrostimulation treatment. Forty females completed the study: 19 in the biofeedback and 21 in the electrostimulation group. Biofeedback or electrostimulation sessions were performed two times daily for eight weeks in each group. Wexner incontinence score, fecal incontinence quality of life scores, and reduced quality of life on visual analog scale were registered before and after treatment. Patients' self-rating of treatment effect also was registered in both groups. The primary outcome measure was the Wexner incontinence score.
  
  
  RESULTS
  There were no differences in treatment effect between groups. Comparing pretreatment status to posttreatment in each group showed no improvement in Wexner score, reduced quality of life, or any of the fecal incontinence quality of life scores. Patients' self-rating of the treatment effect, however, showed a subjective improvement of symptoms both in the biofeedback and in the electrostimulation group (median, 7 vs. 5.)
  
  
  CONCLUSIONS
  This study shows that there was no difference in effect between biofeedback and electrostimulation. Neither biofeedback nor electrostimulation treatments improved Wexner incontinence score, reduced quality of life, or fecal incontinence quality of life scores. Both treatments resulted in improvement of patients' subjective perception of incontinence control.
authors.affiliation: Department of Surgery, Akershus University Hospital, Oslo University, Lorenskog, Norway. nazir.naimy@ahus.no
authors.forename: Nazir
authors.initials: N
authors.lastname: Naimy
authors.forename: Anita Thomassen
authors.initials: AT
authors.lastname: Lindam
authors.forename: Arne
authors.initials: A
authors.lastname: Bakka
authors.forename: Arne Engebritsen
authors.initials: AE
authors.lastname: Faerden
authors.forename: Pål
authors.initials: P
authors.lastname: Wiik
authors.forename: Erik
authors.initials: E
authors.lastname: Carlsen
authors.forename: Britt-Ingjerd
authors.initials: BI
authors.lastname: Nesheim
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000379:methods*; D003672:Defecation / Q000502:physiology; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011788:Quality of Life; D012189:Retrospective Studies; D012421:Rupture; D016896:Treatment Outcome