Outcome and Predictors of Success of Biofeedback for Descending Perineum Syndrome. |
Hur, Le Na , Hwang, Yong Hee , Jung, Yong Hwan |
Department of General Surgery, Seoul Adventist Hospital, Seoul, Korea. lena0224@yahoo.co.kr |
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Abstract |
Purpose To determine the outcome and identify predictors of success of biofeedback for descending perineum syndrome (DPS). Methods 103 patients diagnosed with DPS by defecography were evaluated by standardized questionnaire, before, immediately after treatment, and at follow-up.
Clinical bowel symptoms and anorectal physiological studies were also analyzed. Results At post- biofeedback, 81 patients felt improvement in symptoms, including 29 with complete symptom relief. At follow-up (median: 13 months, n=82), 58 patients felt improvement in symptoms, including 12 with complete symptom relief. There was a significant reduction in difficult defecation (from 78 to 34, 37%, from pre-biofeedback to post-biofeedback, and at follow-up respectively; P<0.001), incomplete defecation (from 88 to 44, 41%; P<0.001), hard stool (from 63 to 25, 0%; P<0.01), small caliber stool (from 63 to 0,0%; P<0.001, P<0.005), fecal incontinence (from 10 to 1,1%; P<0,01), anal pain (from 21 to 2, 6%; P<0.001, P<0.05), laxative use (from 30 to 11, 6%; P<0.001), enema use (from 16 to 0, 1%; P<0.001) and digitation (from 11 to 1%, from pre-biofeedback to at follow-up; P<0.05). Normal spontaneous bowel movement was increased from 47% pre-biofeedback to 79% post-biofeedback (P<0.001), 86% at follow-up (P<0.001). Difficult defecation predict poor outcome (96 vs. 66%; failure vs. success, P<0.01). Positive mean pressure change predict good outcome (69 vs. 35%; success vs. failure, P<0.05). Conclusions Biofeedback is an effective option for DPS. |
Key Words:
Descending perineum syndrome; Biofeedback; Predictors |
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