OBJECTIVE:
to evaluate the effect of sphincter defect (SD) on biofeedback (BF) response in patients with fecal incontinence.
METHODS:
two hundred and forty-two patients with fecal incontinence undergoing BF as exclusive treatment were identified from a BF database. Patients were evaluated with fecal incontinence score (Cleveland Clinic Florida - Fecal Incontinence Score, CCF-FI) and anorectal physiology tests. The pre- and immediate post-treatment outcomes were obtained from the chart, and the long-term outcomes by CCF-FI score that was sent by mail.
RESULTS:
242 patients underwent BF for fecal incontinence. 143 (59.1%) underwent ultrasonography, 43 (30.1%) of whom had sphincter defect detected on US. The immediate outcomes were not affected by the presence of absence of SD. The second CCF-FI questionnaire was mailed after a mean of 6.1 years after treatment. 31 (57.4%) exhibited improvement, 4 (7.4%) remained unchanged, and 19 (35.2%) had worsening function, which was significantly inferior in patients with SD (p = 0.021). Electromyography demonstrated increased electrical activity in the contraction phase after BF in both groups.
CONCLUSIONS:
the majority of patients experience improvement in fecal incontinence after BF. However, patients with SD detected on US prior to treatment seem to have worse function at long term.
Fecal incontinence; Biofeedback; Sphincter defect; Endoanal ultrasound
