Combined Therapy with Electrical Stimulation and Biofeedback for Treating Pelvic Floor Dyssynergia

Min, Hyun Ju; Byeon, Jeong Sik; Myung, Seung Jae; Yang, Suk Kyun; Yoon, In Ja; Kwon, Oh Ryoun; Ko, Jung Eun; Son, Hyun Young; Lee, Hyung Joon; Kim, Jung Sun; Kim, Jin Ho

Abstract

BACKGROUND/AIMS: Although electrical stimulation therapy (EST) has been tried for treating fecal incontinence, there are only limited reports concerning the application of EST to pelvic floor dyssynergia (PFD). We aimed to evaluate the efficacy of combined EST and biofeedback therapy (BFT) for treating PFD. We also checked the substance P expression in the rectum for evaluating the underlying mechanism.
METHODS
Constipated patients who were diagnosed with PFD were randomly divided into two groups. In the EB group, the patients first underwent EST and then BFT. In the BE group, BFT was applied first and then EST was performed. In both groups, the measurement the symptoms and performing anorectal manometry and immunohistochemical staining for substance P in the rectal mucosa were done before and after administering therapies.
RESULTS
Forty patients were analyzed. The baseline characteristics and substance P expression were not different between the EB and BE groups. The patient's symptoms were improved after the first and second therapy, and the proportion of improved patients after both therapies did not differ between the two groups. The anorectal manometric parameters with the patient resting anal the sphincter pressure were significantly decreased in the BE group, but, these tended to show decreases in the EB group. The expression of substance P also did not change before and after the therapies.
CONCLUSIONS
EST alone showed therapeutic efficacy for treating PFD and it produced additional improvement of symptoms when combined with BFT.