Biofeedback in the management of partial anal incontinence

Fifty patients with anal incontinence were treated by biofeedback as an office procedure. This took the form of an intra-anal plug, containing two ring electrodes and connected to an electromyometer. In four or less sessions, patients were instructed in sphincter contraction and extraneous muscle relaxation. All have been followed for at least one year, and in 74 per cent there has been satisfactory restoration of continence. The method was particularly successful in post-surgical (anal) patients, with the exception of those with "keyhole deformity" after anal fistulectomy. In nonsurgical patients, results were excellent in the idiopathic and postradiation groups, but were poor in patients with incontinence due to rectal prolapse or to neurogenic causes. The simplicity and portability of this method make it a valuable aid in the office management of anal incontinence.