Management of post-surgical faecal incontinence due to anorectal malformations by pelvic floor rehabilitation.

Abstract

Many patients with anorectal malformations (ARM) experience a long-lasting problem with faecal incontinence (FI). We assessed the effectiveness of a pelvic floor rehabilitation program including transcutaneous functional electrical stimulation (TFES) in combination with pelvic floor muscle (PFM) exercises on post-surgical FI in children with ARM. Data of 40 children at the age of 4 years or older who had undergone surgical correction for ARM and suffered from persistent FI referring for pelvic floor rehabilitation were analysed respectively. Patients underwent TFES and PFM exercises for 20 sessions. TFES was applied for 20-min during each session, two times a week. A paediatric FI score questionnaire and a bowel habit diary were completed both before and after the treatment for all children. We completed a FI quality of life questionnaire before the therapy and again after treatment for all patients. Twenty-two out of 40 (55%) patients responded completely to the treatment (100% reduction in FI episodes) after the completion of treatment sessions, sustained in 19/40 (47.5%) patients after 6months. Mean ± SD of FI score was 4.9± 3.6 at baseline that significantly reduced to 2.4± 1.3 and 2.4± 1.8 after completion of treatment sessions and 6months later, respectively (P< 0.05). Our results show that TFES and PFM exercises have a considerable beneficial impact on post-surgical FI in children with ARM.