Perineal retraining improves conservative treatment for faecal incontinence: a multicentre randomized study

Area of Science:

• Gastroenterology
• Pelvic Floor Rehabilitation

Background:

• Anal incontinence is a common condition significantly impacting patient quality of life.
• Standard conservative treatments offer limited efficacy for many individuals experiencing anal incontinence.

Purpose of the Study:

• To evaluate the additional benefits of perineal retraining, incorporating biofeedback, to standard medical treatment for anal incontinence.
• To determine if biofeedback therapy enhances patient-reported outcomes in anal incontinence management.

Main Methods:

• A randomized controlled trial was conducted with 157 patients diagnosed with anal incontinence (Wexner score >4).
• Participants were assigned to either standard conservative treatment or perineal retraining with biofeedback.
• Outcomes were assessed using diaries, questionnaires, and satisfaction scores, with self-evaluated improvement as the primary endpoint.

Main Results:

• The perineal retraining group demonstrated a significantly higher success rate (57%) compared to the control group (37%) after 4 months (p<0.021).
• Biofeedback therapy led to significant reductions in stool frequency, leakage, and fecal urgency.
• Perineal retraining was independently associated with a 2.34-fold increased likelihood of self-rated improvement.

Conclusions:

• Perineal retraining, augmented with biofeedback, provides a moderate yet statistically significant benefit for individuals with anal incontinence.
• This approach enhances patient self-perception of improvement and offers a valuable addition to conservative management strategies.