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[Improving continence by biofeedback conditioning]
1Kinderchirurgische Klinik, Johannes Gutenberg-Universität Mainz.
Insights
Biofeedback training (BFT) has helped 72 patients with anal continence issues. This method improved rectal sensation and voluntary contraction, leading to better anal continence in children with various conditions.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Rehabilitation medicine
Background:
- Anal continence disturbances affect numerous children due to conditions like rectoanal agenesis, constipation, and myelomeningocele (MMC).
- Biofeedback training (BFT) has emerged as a therapeutic option for managing these challenging conditions.
- Previous studies have explored various feedback methods, including visual analog feedback and simultaneous audiovisual analog signals.
Purpose of the Study:
- To evaluate the effectiveness of biofeedback training (BFT) in improving anal continence in pediatric patients.
- To analyze the impact of BFT on rectal sensation and voluntary muscle contraction.
- To assess long-term outcomes of BFT in children with diverse anorectal malformations and functional disorders.
Main Methods:
- Retrospective analysis of 72 patients with anal continence disturbances treated with BFT over 10 years.
- Specific focus on 35 children with incontinence following rectoanal agenesis, categorized by infralevator and supralevator defects.
- Utilized visual analog feedback initially, transitioning to simultaneous audiovisual analog signals since 1982.
Main Results:
- BFT demonstrated positive outcomes in patients with anal continence disturbances.
- Improvements were observed in the threshold of rectal sensation and voluntary muscle contraction.
- The study suggests a significant benefit of BFT in achieving and maintaining anal continence.
Conclusions:
- Biofeedback training is an effective therapeutic modality for improving anal continence in children.
- BFT enhances key physiological parameters related to continence, including rectal sensation and voluntary sphincter control.
- Long-term follow-up indicates sustained benefits of BFT for patients with complex anorectal conditions.
Abstract:
In the last 10 years biofeedback training (BFT) has been used in 72 patients with anal continence disturbances following rectoanal agenesis, constipation, MMC, etc. Using the BF-method we treated 35 children with incontinence following rectoanal agenesis (5 infralevator, 30 supralevator). Visual analog feedback was used in the first 10 cases. Since 1982 simultaneous audiovisual analog signals have been preferred. The detailed analysis and personal followup over 6.5 years of these patients suggests that BFT improves the threshold of rectal sensation, voluntary contraction and thereby benefits anal continence.