Hospital, Seoul, Korea Original Article

Purpose: This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and sub-jective bowel function in patients after sphincter-saving surgery for rectal cancer. Methods: Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study. Conservative man-agement included lifestyle modifications, Kegel exercises, and medication. Patients were evaluated at baseline and at 1, 3, 6, and 12 months after ileostomy closure by using anal manometry, modified Wexner Incontinence Scores (WISs), and fe-cal incontinence quality of life (FI-QoL) scores. Results: Before the ileostomy closure, the groups did not differ in baseline clinical characteristics or resting manometric parameters. After 12 months of follow-up, the biofeedback group demonstrated a statistically significant improvement in the mean maximum squeezing pressure (from 146.3 to 178.9, P = 0.002). However, no beneficial effect on the WIS was noted for biofeedback compared to conservative management alone. Overall, the FI-QoL scores were increased signifi-cantly in both groups after ileostomy closure (P = 0.006), but did not differ significantly between the two groups. Conclusion: Although the biofeedback therapy group demonstrated a statistically significant improvement in the maxi-mum squeezing pressure, significant improvements in the WISs and the FI-QoL scores over time were noted in bot