Biofeedback Therapy in Patients with Nonrelaxing Puborectalis Syndrome: Are there differences of therapeutic effect according to methods of diagnosis?

Jeong, Jae Heon; Choi, Jeong Seok; Seo, Yong Jun; Kim, Jun Hyun

Abstract

PURPOSE
To evaluate therapeutic effect of biofeedback therapy according to methods of diagnosis in patients with norelaxing puborectalis syndrome.
METHODS
From September, 1, 1998 to February, 30, 1999, the patients who were diagnosed with norelaxing puborectalis syndrome on anal electromyography (EMG) and/or cinedefecography (CD) underwent biofeedback therapy. The patients were divided into 3 groups according to the diagnostic method; CD group - only diagnosed on cinedefecography, EMG group - only diagnosed on anal electromyography, CD EMG group - diagnosed on both tests.
RESULTS
Nineteen patients were diagnosed nonrelaxing puborectalis syndrome on CD and/or EMG. There were 14 females and 5 males with a mean age of 40.8+/-18.4 years. The patients were classified into CD group; five patients (26.3%); EMG group, eight patients (42.1%); CD EMG group, six patients (31.6%). The patients had 5.4 3.7 sessions of outpatient EMG-based biofeedback sessions. Subjective symptoms after biofeedback therapy improved in 4 (80.0%), 6 (75%), 5 (83%) patients in CD, EMG, CD EMG groups, respectively. There was a statistically significant increase in spontaneous bowel movements, and a reduction in assisted bowel movements after biofeedback therapy in patients in all three groups (p<0.05). However, no significant difference was found among the three groups.
CONCLUSION
This study demonstrated that biofeedback therapy had a high therapeutic effect regardless to the diagnostic method. Therefore, biofeedbck therapy can be performed if one test results in the diagnosis of norelaxing puborectalis syndrome in patients with constipation.