The purpose of this study was to compare intra -anal electromyographic biofeedback alo ne with intra -anal bio-feedback that was augmented with ele ctrical stimulation of the anal sphincter in the treatment o f postpartum fecal in-continence.A secondary aim was to ex amine the impact of the treatment on continencerelated quality of life.Sixty symptomatic women were assigned ran domly to receive in-tra -anal electromyographic biofee dback or electrical stimulation of the anal sphincter on ce weekly for 12weeks and to perform daily pelvic floor exe rcises between treat-ments.Therapeutic response was eva luated with a symp-tom questionnaire to determine cont inence score,anal manometry,and endoanal ultrasound scanning.Quality of life was assessed before and after tr eatment with a validated questionnaire.Fifty -four women co mpleted the treatment;52women(96%)had ultrasonic evidence of an extern al anal sphincter defect.After the tre atment,both groups demonstrated significant improvem ent in continence score(P<.001)and in squeeze anal pressures(P<.04).Resting anal pressures did not alter significantly.Quality of life improved after the completion o f physiotherapy,but there were no differences in outcome between intra -anal electromyographic biofeedback and electrical stimulation of the anal sphincter.Intra -anal elec tromyographic biofeed-back therapy was associated with imp roved continence and quality of life in women with altered fecal continence after delivery.The addition of electrical stimulation of the anal sphincter did not enhance symptomatic outcome.
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