Introduction Biofeedback is safe and effective in the management of rectal evacuatory dysfunction (RED), but there is limited data on medium to long-term follow-up. This study evaluated the effectiveness of biofeedback in the medium-term for patients with RED secondary to pelvic floor dyssynergia (PFD) and rectal hyposensitivity (RH).
Methods Prospective data was collected from 2010 –2013 of 81 consecutive patients who underwent specialist nurse-led verbal biofeedback therapy in the form of rectal sensory re-training or balloon expulsion for PFD or RH. The primary outcome measure was patient satisfaction with their symptom improvement, assessed using a visual analogue scale (Likert scale 0–10). Secondary outcome measures were complete spontaneous bowel movements (CSBMs)/week, time to defecation-assessed using bowel diaries, and KESS/SF-36 quality of life questionnaire scores. All discharged patients received telephone follow-up.
Results 85% patients met the primary outcome measure, with the Likert score improving [mean baseline 3.2 (1–7) vs. post-biofeedback 7.6 (5–9) p < 0.001]. Improvements were seen in CSBMs/week [mean baseline: 3.0 (1–14) vs. post-biofeedback: 6.9 (1–13) P < 0.001] and time taken to defecate in minutes [mean baseline: 18.7 (5–60) vs. post-biofeedback: 8.7(5–30) P < 0.001]. Significant improvements were seen in KESS [mean baseline 13.1 (9–18) vs. post-biofeedback 4.9 (0–16) p < 0.001] and SF-36 scores. Mean number of biofeedback treatments received was four (1–6). 89% of patients discharged still meet the primary endpoint at a mean follow-up of 19 months (range 7–36).
Conclusion Biofeedback has a key role to play in the management of rectal evacuatory dysfunction secondary to pelvic floor dyssynergia and rectal hyposensitivity, with the improvement being maintained in the medium-term.
Disclosure of Interest None Declared.
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