Age- and Sex-related Differences in the Prevalence of Perianal Manual Compression Method Use and the Method's Clinical Effectiveness in Patients with Evacuation Difficulty
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Published on: September 20, 2018
Hideo Watanabe1, Kei Ishimaru2, Yoshito Ono1
1Watanabe Hospital, Matsuyama, Ehime, Japan.
Objectives:
The perianal manual compression method (PMCM) is a form of pelvic floor support used to facilitate defecation. Although PMCM is included in the Rome IV diagnostic criteria for functional constipation as a manual maneuver to facilitate defecation, it has rarely been investigated. This study aimed to investigate age- and sex-related differences in the prevalence of PMCM use and to evaluate its clinical effectiveness in patients with evacuation difficulty (ED).
Methods:
A retrospective survey of 1,400 patients scheduled for hemorrhoid surgery, stratified by age and sex, was conducted to assess the prevalence of PMCM use. In addition, the clinical effectiveness of PMCM was retrospectively evaluated in patients with ED.
Results:
Of 1,380 eligible patients, 94 (6.8%) reported using PMCM. PMCM use was significantly more common in women than in men (9.1% vs. 4.5%, p = 0.0006) and increased with age, particularly in those aged >50 years. Sixty-two patients with ED (median age: 77 years; 30 men) received standardized instruction in PMCM. Of them, 55 were also prescribed laxatives, but 12 did not use PMCM because their symptoms improved with laxatives alone. Of the remaining 50 patients, PMCM was effective in 35 (70%), with 22 (44%) showing marked improvement. The median follow-up period was 2.0 months, and no adverse events related to PMCM were observed.
Conclusion:
PMCM is a simple and noninvasive maneuver that may represent a useful adjunctive therapy for patients with ED who are refractory to laxative therapy.
