- 作者：Henri Damon ; Laurent Siproudhis ; Jean-Luc Faucheron ; Thierry Piche ; Laurent Abramowitz ; Marianne El茅ouet ; Isabelle Etienney ; Philippe Godeberge ; Guy Valancogne ; Ang茅lique Denis ; Fran莽ois Mion ; Anne-Marie Schott ; The Oralia Trial Group
- 关键词：Anal incontinence ; Biofeedback ; Quality of life ; Randomized clinical trial
- 刊名：Digestive and Liver Disease
- 出版年：March, 2014
- 年：2014
- 卷：46
- 期：3
- 页码：237-242
- 全文大小：467 K
Background
Anal incontinence is a frequent complaint that profoundly affects quality of life. Our aim was to determine whether perineal retraining gives additional benefits to standard medical treatment.Methods
Patients with anal incontinence and a Wexner score >4 were randomly assigned to standard conservative treatment (control) or perineal retraining, including biofeedback, in addition to standard treatments (biofeedback). Diaries, self-administered questionnaires and satisfaction scores quantified the benefits. Self-evaluated improvement was the primary outcome measure. A score 鈮? (in an improvement scale from 鈭? to +5) defined success.
Results
Overall, 157 patients were included; 80 in the control group (75% females, mean age 60.1 卤 13.2 years) and 77 in the biofeedback group (79% females, mean age 61.9 卤 10.2 years). After a 4-month follow-up, the success rate was significantly higher in the biofeedback group (57% versus 37%; p < 0.021). In the biofeedback group, daily stool frequency, leakage, and faecal urgency significantly decreased, and daily non-urgent perception of stool increased. Conversely, symptomatic scores and quality of life scales did not significantly differ between groups. In a multivariate model, the adjusted odds ratio showed that perineal retraining was significantly associated with a higher chance of self-rated improvement (adjusted Odd Ratio [95%CI]: 2.34 [1.14-4.80]; p = 0.021).
Conclusions
Perineal retraining offers a moderate but significant benefit for patients suffering from anal incontinence.