Management of anal incontinence by biofeedback

Abstract

One hundred thirteen patients with anal incontinence, in whom conventional sphincter exercises were ineffective, were treated by biofeedback, 89 in the office and 24 in the hospital rehabilitation department. Equipment consisted of an intraanal plug, containing two electrodes, connected to an electromyometer. In the last 16 cases, an Apple computer was added. With the plug in place and the electromyometer or computer screen in view, patients were instructed in sphincter contraction during an average of 3.34 1-h sessions. Follow-up was 6 mo to 5 yr, with no relapses. Sixty-three percent had either complete recovery of continence or at least a 90% decrease in the frequency of incontinence. When 13 cases of "keyhole deformity" were excluded, the success rate rose to 71%. This method is simple, inexpensive, and suitable for either office or hospital management of anal incontinence.