Obstructed defaecation: what is the role of rehabilitation?
Article first published online: 5 MAR 2012
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland
Volume 14, Issue 4, pages 474–479, April 2012
How to Cite
Pucciani, F., Reggioli, M. and Ringressi, M. N. (2012), Obstructed defaecation: what is the role of rehabilitation?. Colorectal Disease, 14: 474–479. doi: 10.1111/j.1463-1318.2011.02644.x
- Issue published online: 5 MAR 2012
- Article first published online: 5 MAR 2012
- Accepted manuscript online: 15 APR 2011 10:40AM EST
- Received 3 November 2010; accepted 9 February 2011; Accepted Article online 15 April 2011
- Obstructed defaecation;
- multimodal rehabilitation programme;
- anorectal manometry
Aim The study was designed to evaluate the results of rehabilitative treatment in patients suffering from obstructed defaecation.
Method Between January 2008 and July 2010, 39 patients (37 women, age range 25–73 years; and two men, aged 57 and 67 years) affected by obstructed defaecation were included in the study. After a preliminary clinical evaluation, including the Obstructed Defaecation Syndrome (ODS) score, defaecography and anorectal manometry were performed. All 39 patients underwent rehabilitative treatment according to the ‘multimodal rehabilitative programme’ for obstructive defaecation. At the end of the programme, all 39 patients were reassessed by clinical evaluation and anorectal manometry. Postrehabilition ODS scores were used to categorize patients arbitrarily into three classes, as follows: class I, good (score ≤ 4); class II, fair (score > 4 to ≤ 8); and class III, poor (score > 8).
Results After rehabilitation, there was significant improvement in the overall mean ODS score (P < 0.001). Thirty (76.9%) patients were included as class I (good results), of whom eight (20.5%) were symptom free. Five (12.8%) patients were considered class III. A significant postrehabilitative direct correlation was found between ODS score and pelvic surgery (ρs = 0.54; P < 0.05). Significant differences were found between pre- and postrehabilitative manometric data from the straining test (P < 0.001), duration of maximal voluntary contraction (P < 0.001) and conscious rectal sensitivity threshold (P < 0.02).
Conclusion After rehabilitation, some patients become symptom free and many had an improved ODS score.