Abstract
Introduction: Myelomeningocele is one of the most complex birth defects that cause physical disability, with consequent fecal incontinence and therefore difficulty in social integration of these patients. Objective: To improve the quality of life and manometric values after biofeedback therapy. Method: Longitudinal, prospective, analytical and experimental study. Patients with myelomeningocele and fecal incontinence who were between 5 to 15 years old and their parents were included in the study. Child and parent reports of PedsQMtm generic questionnaire were collected after obtaining informed consent and assent. Anorectal manometry and first biofeedback sessions were held with each child. Following treatment completion, the PedsQMtm was applied again. Results: 17 children and their parents were included in the study. All the patients presented fecal incontinence and an inability to voluntarily evacuate rectal contents. After biofeedback, the totality of patients improved their fecal incontinence. Nine of them stop using diaper. All reported successful use of the toilet. Statistically significant differences were observed when comparing the quality of life of children and parents at the beginning and at the end of treatment. There was an improvement in quality of life after the treatment with biofeedback for both children and parents, which was more perceived by these. Conclusions: It is highly significant for the improvement both in clinic and manometric values. The improvement in quality of life is more evident in the parents.
Highlights
Myelomeningocele is one of the most complex birth defects that cause physical disability, with consequent fecal incontinence and difficulty in social integration of these patients
We propose the re-education of the anal sphincter through bio-feedback as the treatment of fecal incontinence
The objective of this work is to improve the quality of life of children with myelomeningocele with an age between 5 and 15 years, with fecal incontinence, assisted in our hospital by performing recto-anal manometry followed by session of biofeedback
Summary
Myelomeningocele is one of the most complex birth defects that cause physical disability, with consequent fecal incontinence and difficulty in social integration of these patients. Objective: To improve the quality of life and manometric values after biofeedback therapy. Patients with myelomeningocele and fecal incontinence who were between 5 to 15 years old and their parents were included in the study. Results: 17 children and their parents were included in the study. The totality of patients improved their fecal incontinence. Significant differences were observed when comparing the quality of life of children and parents at the beginning and at the end of treatment. There was an improvement in quality of life after the treatment with biofeedback for both children and parents, which was more perceived by these. There is a psychologic damage resulting in loss of self esteem and derangement of quality of life [7] [8].
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