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International Journal of Colorectal Disease

, Volume 23, Issue 5, pp 503–511

First Online: 29 January 2008Accepted: 08 January 2008

Abstract

PurposePelvic-floor rehabilitation does not provide the same degree of relief in all fecal incontinent patients. We aimed at studying prospectively the ability of tests to predict the outcome of pelvic-floor rehabilitation in patients with fecal incontinence.

Materials and methodsTwo hundred fifty consecutive patients 228 women underwent medical history and a standardized series of tests, including physical examination, anal manometry, pudendal nerve latency testing, anal sensitivity testing, rectal capacity measurement, defecography, endoanal sonography, and endoanal magnetic resonance imaging. Subsequently, patients were referred for pelvic-floor rehabilitation. Outcome of pelvic-floor rehabilitation was quantified by the Vaizey incontinence score. Linear regression analyses were used to identify candidate predictors and to construct a multivariable prediction model for the posttreatment Vaizey score.

ResultsAfter pelvic-floor rehabilitation, the mean baseline Vaizey score 18, SD ± 3 was reduced with 3.2 points p < 0.001. In addition to the baseline Vaizey score, three elements from medical history were significantly associated with the posttreatment Vaizey score presence of passive incontinence, thin stool consistency, primary repair of a rupture after vaginal delivery at childbed R, 0.18. The predictive value was significantly but marginally improved by adding the following test results: perineal and-or perianal scar tissue physical examination, and maximal squeeze pressure anal manometry; R, 0.20; p = 0.05.

ConclusionAdditional tests have a limited role in predicting success of pelvic-floor rehabilitation in patients with fecal incontinence.

KeywordsFecal incontinence Outcome prediction Diagnostic tests Biofeedback Electrical stimulation therapy Pelvic floor  Download fulltext PDF



Autor: M. P. Terra - M. Deutekom - A. C. Dobben - C. G. M. I. Baeten - L. W. M. Janssen - G. E. E. Boeckxstaens - A. F. 

Fuente: https://link.springer.com/article/10.1007/s00384-008-0438-8



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