A Practical Guide to Biofeedback Therapy for Pelvic Floor Disorders

Curr Gastroenterol Rep. 2019 Apr 23;21(5):21. doi: 10.1007/s11894-019-0688-3.

Abstract

Purpose of review: Biofeedback therapy (BFT) is effective for managing pelvic floor disorders (i.e., defecatory disorders and fecal incontinence). However, even in controlled clinical trials, only approximately 60% of patients with defecatory disorders experienced long-term improvement. The review serves to update practitioners on recent advances and to identify practical obstacles to providing biofeedback therapy.

Recent findings: The efficacy and safety of biofeedback therapy have been evaluated in defecatory disorders, fecal incontinence, and levator ani syndrome. Recent studies looked at outcomes in specific patient sub-populations and predictors of a response to biofeedback therapy. Biofeedback therapy is effective for managing defecatory disorders, fecal incontinence, and levator ani syndrome. Patients who have a lower bowel satisfaction score and use digital maneuvers fare better. Biofeedback therapy is recommended for patients with fecal incontinence who do not respond to conservative management. A subset of patients with levator ani syndrome who have dyssynergic defecation are more likely to respond to biofeedback therapy.

Keywords: Biofeedback therapy; Defecation disorder; Fecal incontinence; Levator ani syndrome; Pelvic floor dysfunction.

Publication types

  • Review

MeSH terms

  • Anus Diseases / etiology
  • Anus Diseases / physiopathology
  • Anus Diseases / therapy*
  • Biofeedback, Psychology / methods*
  • Constipation / etiology
  • Constipation / physiopathology
  • Constipation / therapy*
  • Defecation / physiology
  • Fecal Incontinence / etiology
  • Fecal Incontinence / therapy*
  • Humans
  • Pain / etiology
  • Pain / physiopathology
  • Pelvic Floor / physiopathology
  • Pelvic Floor Disorders / complications
  • Pelvic Floor Disorders / physiopathology
  • Pelvic Floor Disorders / therapy*

Supplementary concepts

  • Levator syndrome