Elektrostimulation und Biofeedback-Beckenbodenmuskeltraining bei Patienten mit Stuhlinkontinenz

Autor: Bary Berghmans, Lucas W. M. Janssen, Ruud Schouten, Bart Bijnen, Richelle J. F. Felt-Bersma, Frederik J. M. Slors, Guy E. Boeckxstaens, Marije Deutekom, Jacob Stoker, Cor G. M. I. Baeten, Annette C. Dobben, Maaike P. Terra, Patrick M.M. Bossuyt, E. Everhardt, Michael F. Gerhards, Alexander Engel
Přispěvatelé: Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, APH - Personalized Medicine, APH - Methodology, Amsterdam Public Health, Epidemiology and Data Science
Rok vydání: 2007
Předmět:
Zdroj: Coloproctology, 29(2), 75-86. Springer-Verlag Italia
ISSN: 1615-6730
0174-2442
DOI: 10.1007/s00053-007-7007-4
Popis: 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 ≥ 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.
Databáze: OpenAIRE
Externí odkaz: