Predictors of Unsuccessful of Treatment for Fecal Incontinence Biofeedback for Fecal Incontinence in Female

Abstract

BACKGROUND: Biofeedback is an effective method of treatment for fecal incontinence but there is controversy regarding factors that may be correlated with its effectiveness. OBJECTIVE: To evaluate the efficacy of biofeedback in the treatment of fecal incontinence, identifying the predictive factors for unsuccessful treatment. METHODS: Consecutive female patients who had fecal incontinence and were treated with a full course of biofeedback were screened. The symptoms were evaluated using Cleveland Clinic incontinence (CCF) score before and six months after the completion of therapy. Patients had a satisfactory clinical response to biofeedback if the CCF score had decreased by more than 50% at six months (GI) and an unsatisfactory response if the CCF score did not decrease or if the score decreased by <50% (GII). The groups were compared with regard to age, score, anal resting and squeeze pressures and sustained squeeze pressure by manometry, history of vaginal delivery, number of vaginal deliveries, menopause, hysterectomy, and previous anorectal surgery. RESULTS: Of 124 women were included, 70 (56%) in GI and 54 (44%) in GII. The median CCF score decreased significantly from 10 to 5 (P=0.00). FI scores were higher in GII. Patients from GII had more previous vaginal deliveries and previous surgeries. The mean sustained squeeze pressure was higher in GI. Patients from GI and GII had similar ages, number of vaginal deliveries, menopause, hysterectomy, anal pressures, and sphincter defects. The median sustained squeeze pressure increased significantly before and after biofeedback in GI. CONCLUSION: Biofeedback therapy shows effective treatment with 50% reductions in FI score in half of patients. Factors associated with unsuccessful outcome include FI score ≥10, previous vaginal delivery, previous anorectal and/or colorectal surgery, and reduced mean sustained squeeze pressure.

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

“…61,83,122,125,141,142, 146,170,183,199,200,227,251,253,258,261,264,285,296,298,302,353 Endoanal ultrasonography was performed in 104 studies (34.0%). 53,65,72,73,76–78,80,83,86,90,92,104,105,109,110,113, 115,122,125,127,133,141,142,146,151–153,155,157,162,163,165,167,172–176,178,179,183,191,193,…”

“…Anal manometry was used in 126 studies (41.2%) 50 , 53 , 55 , 57 , 61 , 65 , 72 , 73 , 77 , 78 , 80 , 82 , 83 , 85 , 86 , 91 , 92 , 95 , 96 , 98 , 103–107 , 109 , 111 , 115 , 122 , 123 , 125 , 127 , 134 , 141 , 142 , 146 , 151–153 , 155 , 162–165 , 167 , 168 , 170 , 174–176 , 178 , 179 , 183 , 191 , 193 , 199–201 , 204 , 206 , 213 , 217 , 218 , 223 , 227 , 228 , 230 , 234 , 236 , 237 , 239 , 240 , 244–251 , …”

Predictive parameters to identify incontinent patients amenable for rehabilitation treatment: the muscular synergies evaluation

“…We have read with great interest the article "Predictors of unsuccessful of treatment for fecal incontinence biofeedback for fecal incontinence in female" by Murad-Regadas SM et al (1) . We congratulate the journal and the Authors for the publication of a paper on the indications, outcomes and modality of biofeedback treatment in patients with fecal incontinence.…”

Anorectal Functional Disorders: Towards a Better Diagnosis and Treatment

“…The third paper by Murad-Regadas SM (8) evaluated prospectively the outcome of biofeedback (BF) treatment for fecal incontinence.…”

“…The study of Murad-Regadas SM et al (8) , as in the study of Terra MP et al (10) , analyzed the results of BF treatment for incontinent patients, looking for prognostic factor that my influence results. It is also suggested that a faster track might be used in the up scaling of treatment for this patients, rising the question: should bad prognoses patients be submitted to a full, time and cost consuming, BF protocol to achieve a frustrating result, in this often depressed patients, or should they start a different approach to achieve a better chance of response?…”