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Korean J Pediatr Gastroenterol Nutr. 2007 Mar;10(1):51-59. Korean.
Published online Mar 31, 2007.  https://doi.org/10.5223/kjpgn.2007.10.1.51
Copyright © 2007 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia
Kie Young Park, Soo Hee Chang,* and Kyung Mo Kim
Department of Pediatrics, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.
*Department of Pediatrics, Bundang Jesaeng General Hospital, Seongnam, Korea.
Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Abstract

PURPOSE

Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD.

METHODS

We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later.

RESULTS

Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the short- term improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy.

CONCLUSION

Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

Keywords: Pelvic floor dyssynergia; Biofeedback therapy; Chronic constipation; Children