Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients

M.P. Terra, A.C. Dobben, B.C. Berghmans, M. Deutekom, C.G. Baeten, L.W. Janssen, G.E. Boeckxstaens, A.F. Engel, R.J. Felt Bersma, J.F. Slors, M.F. Gerhards, A.B. Bijnen, E. Everhardt, W.R. Schouten, P.M.M. Bossuyt, J. Stoker

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Abstract

PURPOSE: Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies. METHODS: A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings. RESULTS: Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups. CONCLUSIONS: Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation.
Original languageEnglish
Pages (from-to)1149-1159
JournalDiseases of the Colon & Rectum
Volume49
Issue number8
DOIs
Publication statusPublished - 1 Jan 2006

Cite this

Terra, M.P. ; Dobben, A.C. ; Berghmans, B.C. ; Deutekom, M. ; Baeten, C.G. ; Janssen, L.W. ; Boeckxstaens, G.E. ; Engel, A.F. ; Felt Bersma, R.J. ; Slors, J.F. ; Gerhards, M.F. ; Bijnen, A.B. ; Everhardt, E. ; Schouten, W.R. ; Bossuyt, P.M.M. ; Stoker, J. / Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients. In: Diseases of the Colon & Rectum. 2006 ; Vol. 49, No. 8. pp. 1149-1159.
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title = "Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients",
abstract = "PURPOSE: Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies. METHODS: A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings. RESULTS: Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups. CONCLUSIONS: Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation.",
author = "M.P. Terra and A.C. Dobben and B.C. Berghmans and M. Deutekom and C.G. Baeten and L.W. Janssen and G.E. Boeckxstaens and A.F. Engel and {Felt Bersma}, R.J. and J.F. Slors and M.F. Gerhards and A.B. Bijnen and E. Everhardt and W.R. Schouten and P.M.M. Bossuyt and J. Stoker",
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Terra, MP, Dobben, AC, Berghmans, BC, Deutekom, M, Baeten, CG, Janssen, LW, Boeckxstaens, GE, Engel, AF, Felt Bersma, RJ, Slors, JF, Gerhards, MF, Bijnen, AB, Everhardt, E, Schouten, WR, Bossuyt, PMM & Stoker, J 2006, 'Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients', Diseases of the Colon & Rectum, vol. 49, no. 8, pp. 1149-1159. https://doi.org/10.1007/s10350-006-0569-3

Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients. / Terra, M.P.; Dobben, A.C.; Berghmans, B.C.; Deutekom, M.; Baeten, C.G.; Janssen, L.W.; Boeckxstaens, G.E.; Engel, A.F.; Felt Bersma, R.J.; Slors, J.F.; Gerhards, M.F.; Bijnen, A.B.; Everhardt, E.; Schouten, W.R.; Bossuyt, P.M.M.; Stoker, J.

In: Diseases of the Colon & Rectum, Vol. 49, No. 8, 01.01.2006, p. 1149-1159.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Electrical stimulation and pelvic floor muscle training with biofeedback in patients with fecal incontinence: a cohort study of 281 patients

AU - Terra, M.P.

AU - Dobben, A.C.

AU - Berghmans, B.C.

AU - Deutekom, M.

AU - Baeten, C.G.

AU - Janssen, L.W.

AU - Boeckxstaens, G.E.

AU - Engel, A.F.

AU - Felt Bersma, R.J.

AU - Slors, J.F.

AU - Gerhards, M.F.

AU - Bijnen, A.B.

AU - Everhardt, E.

AU - Schouten, W.R.

AU - Bossuyt, P.M.M.

AU - Stoker, J.

PY - 2006/1/1

Y1 - 2006/1/1

N2 - PURPOSE: Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies. METHODS: A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings. RESULTS: Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups. CONCLUSIONS: Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation.

AB - PURPOSE: Pelvic floor rehabilitation is an appealing treatment for patients with fecal incontinence but reported results vary. This study was designed to assess the outcome of pelvic floor rehabilitation in a large series of consecutive patients with fecal incontinence caused by different etiologies. METHODS: A total of 281 patients (252 females) were included. Data about medical history, anal manometry, rectal capacity measurement, and endoanal sonography were collected. Subgroups of patients were defined by anal sphincter complex integrity, and nature and possible underlying causes of fecal incontinence. Subsequently patients were referred for pelvic floor rehabilitation, comprising nine sessions of electric stimulation and pelvic floor muscle training with biofeedback. Pelvic floor rehabilitation outcome was documented with Vaizey score, anal manometry, and rectal capacity measurement findings. RESULTS: Vaizey score improved from baseline in 143 of 239 patients (60 percent), remained unchanged in 56 patients (23 percent), and deteriorated in 40 patients (17 percent). Mean Vaizey score reduced with 3.2 points (P < 0.001). A Vaizey score reduction of >or= 50 percent was observed in 32 patients (13 percent). Mean squeeze pressure (+5.1 mmHg; P = 0.04) and maximal tolerated volume (+11 ml; P = 0.01) improved from baseline. Resting pressure (P = 0.22), sensory threshold (P = 0.52), and urge sensation (P = 0.06) remained unchanged. Subgroup analyses did not show substantial differences in effects of pelvic floor rehabilitation between subgroups. CONCLUSIONS: Pelvic floor rehabilitation leads overall to a modest improvement in severity of fecal incontinence, squeeze pressure, and maximal tolerated volume. Only in a few patients, a substantial improvement of the baseline Vaizey score was observed. Further studies are needed to identify patients who most likely will benefit from pelvic floor rehabilitation.

U2 - 10.1007/s10350-006-0569-3

DO - 10.1007/s10350-006-0569-3

M3 - Article

VL - 49

SP - 1149

EP - 1159

JO - Diseases of the Colon & Rectum

JF - Diseases of the Colon & Rectum

SN - 0012-3706

IS - 8

ER -