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Biofeedback therapy in rectal prolapse patients
K J Hämäläinen1, P Raivio, S Antila
1Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.
Purpose:
The aim of the study was to evaluate the effect of perioperative biofeedback training on postoperative continence in patients with rectal prolapse.
Methods:
Thirty-six consecutive patients were operated on between 1987 and 1993. Twenty-nine could be traced for reexamination. Four were excluded because of a recurring prolapse. Anal manometry, assessment of rectoanal sensation, and surface electromyography were performed during the reexamination. From 1987 to 1991, no perioperative biofeedback training was given (Group 1, n = 14). Since the beginning of 1992, incontinent patients were given biofeedback training (Group 2, n = 11).
Results:
Continence scores improved in both study groups. Both study groups had equally low resting pressures compared with Group 3 (controls) (30.6 +/- 14.9 vs. 53.0 +/- 11.9 mmHg; P < 0.001). Anal resting pressure correlated with postoperative continence score, whereas contractile pressures did not (r = -0.5,P < 0.05, and r = -0.3, p = not significant, respectively).
Conclusion:
Biofeedback therapy can improve the function of external sphincter; however, the most important reason for postoperative incontinence in rectal prolapse patients is low resting pressure that cannot be corrected by biofeedback therapy.