Pelvic floor rehabilitation for defecation disorders

R Bocchini¹, G Chiarioni^{2

3}, E Corazziari⁴, F Pucciani⁵, F Torresan⁶, P Alduini⁷, G Bassotti⁸, E Battaglia⁹, F Ferrarini¹⁰, F Galeazzi¹¹, C Londoni¹², P Rossitti¹³, P Usai Satta¹⁴, L Iona¹⁵, S Marchi¹⁶, G Milazzo¹⁷, D F Altomare¹⁸, R Barbera¹⁹, A Bove²⁰, C Calcara²¹, L D'Alba²², M De Bona²³, F Goffredo²⁴, G Manfredi²⁵, G Naldini²⁶, M C Neri²⁷, L Turco²⁸, F La Torre²⁹, A P D'Urso³⁰, I Berni³¹, M A Balestri²⁶, N Busin³², C Boemo¹⁵, M Bellini³³

Affiliations

¹ Gastroenterology Unit, Malatesta Novello Private Hospital, Cesena, Italy. renboc@tin.it.
² RFF Division of Gastroenterology, University of Verona, Verona, Italy.
³ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ Department of Gastroenterology, Istituto Clinico Humanitas, Milan, Italy.
⁵ Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
⁶ Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
⁷ Gastroenterology and Endoscopy Unit, San Luca Hospital, Lucca, Italy.
⁸ Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.
⁹ Gastroenterology and Endoscopy Unit, Cardinal Massaia Hospital, Asti, Italy.
¹⁰ Endoscopy Unit, San Clemente Private Hospital, Mantua, Italy.
¹¹ Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
¹² Gastroenterology and Endoscopy Unit, ASST "Maggiore", Crema, Cremona, Italy.
¹³ Gastroenterology Unit, S. Maria della Misericordia Hospital, Udine, Italy.
¹⁴ Gastroenterology Unit, G. Brotzu Hospital, Cagliari, Italy.
¹⁵ Early Rehabilitation Department, S. Maria della Misericordia Hospital, Udine, Italy.
¹⁶ Gastrointestinal Unit, Departmentt. of General Surgery, University of Pisa, Pisa, Italy.
¹⁷ U.O.Lungodegenza e Medicina, Ospedale Vittorio Emanuele III, Salemi, Tp, Italy.
¹⁸ Department of Emergency and Organ Transplantation (DETO) and Interdepart mental Research Center for Pelvic Floor Dysfunction (CIRPAP), University Aldo Moro, Policlinico, Bari, Italy.
¹⁹ San Giuseppe Multimedica Hospital, Milan, Italy.
²⁰ Gastroenterology and Endoscopy Unit, Department of Gastroenterology, A. Cardarelli Hospital, Naples, Italy.
²¹ Gastroenterology Unit, SSVD Gastroenterologia, Ospedale SS Trinità, Borgomanero, No, Italy.
²² Gastroenterology and Digestive Endoscopy Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
²³ Gastroenterology and Endoscopy Unit, Feltre Hospital, Feltre, Bl, Italy.
²⁴ Gastroenterology and Endoscopy Unit, San Camillo-Forlanini Hospital, Rome, Italy.
²⁵ Department of Gastroenterology and Digestive Endoscopy, Crema Hospital, ASST CREMA, Crema, Italy.
²⁶ Proctological and Perineal Surgery Unit, Cisanello University Hospital, Pisa, Italy.
²⁷ Gastroenterology Unit, Geriatric Institute "Pio Albergo Trivulzio", Milan, Italy.
²⁸ Department of Digestive Physiopathology, Healte Center "Cittadella della Salute", Lecce, Italy.
²⁹ Department of Surgical Sciences, University "La Sapienza", Policlinico Umberto I, Rome, Italy.
³⁰ Policlinico Morgagni, Catania, Italy.
³¹ Rehabilitation Department, San Luca Hospital, Lucca, Italy.
³² Rehabilitation Department, Villa Igea Private Hospital, Forlì, Italy.
³³ Gastrointestinal Unit, Department of General Surgery, University of Pisa, Pisa, Italy.

PMID: 30631977
DOI: 10.1007/s10151-018-1921-z

Review

Pelvic floor rehabilitation for defecation disorders

R Bocchini et al. Tech Coloproctol. 2019 Feb.

. 2019 Feb;23(2):101-115.

doi: 10.1007/s10151-018-1921-z. Epub 2019 Jan 10.

Authors

Affiliations

¹ Gastroenterology Unit, Malatesta Novello Private Hospital, Cesena, Italy. renboc@tin.it.
² RFF Division of Gastroenterology, University of Verona, Verona, Italy.
³ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ Department of Gastroenterology, Istituto Clinico Humanitas, Milan, Italy.
⁵ Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
⁶ Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
⁷ Gastroenterology and Endoscopy Unit, San Luca Hospital, Lucca, Italy.
⁸ Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy.
⁹ Gastroenterology and Endoscopy Unit, Cardinal Massaia Hospital, Asti, Italy.
¹⁰ Endoscopy Unit, San Clemente Private Hospital, Mantua, Italy.
¹¹ Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
¹² Gastroenterology and Endoscopy Unit, ASST "Maggiore", Crema, Cremona, Italy.
¹³ Gastroenterology Unit, S. Maria della Misericordia Hospital, Udine, Italy.
¹⁴ Gastroenterology Unit, G. Brotzu Hospital, Cagliari, Italy.
¹⁵ Early Rehabilitation Department, S. Maria della Misericordia Hospital, Udine, Italy.
¹⁶ Gastrointestinal Unit, Departmentt. of General Surgery, University of Pisa, Pisa, Italy.
¹⁷ U.O.Lungodegenza e Medicina, Ospedale Vittorio Emanuele III, Salemi, Tp, Italy.
¹⁸ Department of Emergency and Organ Transplantation (DETO) and Interdepart mental Research Center for Pelvic Floor Dysfunction (CIRPAP), University Aldo Moro, Policlinico, Bari, Italy.
¹⁹ San Giuseppe Multimedica Hospital, Milan, Italy.
²⁰ Gastroenterology and Endoscopy Unit, Department of Gastroenterology, A. Cardarelli Hospital, Naples, Italy.
²¹ Gastroenterology Unit, SSVD Gastroenterologia, Ospedale SS Trinità, Borgomanero, No, Italy.
²² Gastroenterology and Digestive Endoscopy Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
²³ Gastroenterology and Endoscopy Unit, Feltre Hospital, Feltre, Bl, Italy.
²⁴ Gastroenterology and Endoscopy Unit, San Camillo-Forlanini Hospital, Rome, Italy.
²⁵ Department of Gastroenterology and Digestive Endoscopy, Crema Hospital, ASST CREMA, Crema, Italy.
²⁶ Proctological and Perineal Surgery Unit, Cisanello University Hospital, Pisa, Italy.
²⁷ Gastroenterology Unit, Geriatric Institute "Pio Albergo Trivulzio", Milan, Italy.
²⁸ Department of Digestive Physiopathology, Healte Center "Cittadella della Salute", Lecce, Italy.
²⁹ Department of Surgical Sciences, University "La Sapienza", Policlinico Umberto I, Rome, Italy.
³⁰ Policlinico Morgagni, Catania, Italy.
³¹ Rehabilitation Department, San Luca Hospital, Lucca, Italy.
³² Rehabilitation Department, Villa Igea Private Hospital, Forlì, Italy.
³³ Gastrointestinal Unit, Department of General Surgery, University of Pisa, Pisa, Italy.

PMID: 30631977
DOI: 10.1007/s10151-018-1921-z

Abstract

Pelvic floor rehabilitation is frequently recommended for defecation disorders, in both constipation and fecal incontinence. However, the lack of patient selection, together with the variety of rehabilitation methods and protocols, often jeopardize the results of this approach, causing difficulty in evaluating outcomes and addressing proper management, and above all, in obtaining scientific evidence for the efficacy of these methods for specific indications. The authors represent different gastroenterological and surgical scientific societies in Italy, and their aim was to identify the indications and agree on treatment protocols for pelvic floor rehabilitation of patients with defecation disorders. This was achieved by means of a modified Delphi method, utilizing a working team (10 members) which developed the statements and a consensus group (15 members, different from the previous ones) which voted twice also suggesting modifications of the statements.

Keywords: Biofeedback; Defecation disorders; Guidelines.

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Comment in

An imaginary cuboid: chest, abdomen, vertebral column and perineum, different parts of the same whole in the harmonic functioning of the pelvic floor.
Brusciano L, Gambardella C, Tolone S, Del Genio G, Terracciano G, Gualtieri G, Schiano di Visconte M, Docimo L. Brusciano L, et al. Tech Coloproctol. 2019 Jun;23(6):603-605. doi: 10.1007/s10151-019-01996-x. Epub 2019 May 7. Tech Coloproctol. 2019. PMID: 31065825 No abstract available.

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Pelvic floor rehabilitation for defecation disorders

Affiliations

Pelvic floor rehabilitation for defecation disorders

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Medical