A prospective, randomized study comparing the effect of augmented biofeedback with sensory biofeedback alone on fecal incontinence after obstetric trauma

PURPOSE: This study was designed to compare prospectively the effects of au gmented biofeedback with those of sensory biofeedback alone on fecal incont inence and anorectal manometry after obstetric trauma. METHODS: A consecuti ve cohort of 40 females with impaired fecal continence after obstetric anal sphincter injury were recruited from a dedicated perineal clinic. Patients were randomly assigned to receive either augmented biofeedback or sensory biofeedback alone. All patients were assessed before and after twelve weeks of biofeedback training, using a fecal continence questionnaire and anorec tal manometry. RESULTS: Thirty-nine of 40 females recruited completed the s tudy. Continence scores improved in both treatment groups. but the results were better for those who received augmented biofeedback. Anorectal manomet ry was unchanged by sensory biofeedback, whereas anal resting and squeeze p ressures increased with augmented biofeedback. No change in anal vector sym metry was observed in either group. CONCLUSION: Augmented biofeedback train ing is superior to sensory biofeedback alone in the treatment of impaired f ecal continence after obstetric trauma.