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KMID : 0356720070230030145
Journal of the Korean Society of Coloproctology
2007 Volume.23 No. 3 p.145 ~ p.151
Outcome and Predictors of Success of Biofeedback for Descending Perineum Syndrome
Hur Le-Na

Hwang Yong-Hee
Jung Yong-Hwan
Abstract
Purpose: To determine the outcome and identify predictors of success of biofeedback for descending perineum syndrome (DPS).

Methods: 103 patients diagnosed with DPS by defecography were evaluated by standardized questionnaire, before, immediately after treatment, and at follow-up. Clinical bowel symptoms and anorectal physiological studies were also analyzed.

Results: At post- biofeedback, 81 patients felt improvement in symptoms, including 29 with complete symptom relief. At follow-up (median: 13 months, n=82), 58 patients felt improvement in symptoms, including 12 with complete symptom relief. There was a significant reduction in difficult defecation (from 78 to 34, 37%, from pre-biofeedback to post-biofeedback, and at follow-up respectively; P£¼0.001), incomplete defecation (from 88 to 44, 41%; P£¼0.001), hard stool (from 63 to 25, 0%; P£¼0.01), small caliber stool (from 63 to 0,0%; P£¼0.001, P£¼0.005), fecal incontinence (from 10 to 1,1%; P£¼0,01), anal pain (from 21 to 2, 6%; P£¼0.001, P£¼0.05), laxative use (from 30 to 11, 6%; P£¼0.001), enema use (from 16 to 0, 1%; P£¼0.001) and digitation (from 11 to 1%, from pre-biofeedback to at follow-up; P£¼0.05). Normal spontaneous bowel movement was increased from 47% pre-biofeedback to 79% post-biofeedback (P£¼0.001), 86% at follow-up (P£¼0.001). Difficult defecation predict poor outcome (96 vs. 66%; failure vs. success, P£¼0.01). Positive mean pressure change predict good outcome (69 vs. 35%; success vs. failure, P£¼0.05).

Conclusions: Biofeedback is an effective option for DPS. J Korean Soc Coloproctol 2007;23:145-151
KEYWORD
escending perineum syndrome, Biofeedback, Predictors
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