Treatment of idiopathic anal incotinence: Combined transanal electrostimulation and biofeedback therapy

Idiopathic fecal incontinence, a disruptive condition, can be physically and emotionally debilitating. Many therapeutic modalities, including overlapping postanal sphincteroplasty, gracilis muscle transposition, and artificial sphincter implantation, have produced disappointing results. Transanal electrostimulation of the anal sphincters and biofeedback therapy have recently been proposed to treat idiopathic anal incontinence. This study evaluated the effectiveness of these two methods of treating this disorder. One hundred patients diagnosed with idiopathic anal incontinence were enrolled in this study. Their age distribution ranged from 45 to 80 years, with a mean of 65 years. The male to female ratio was 42:58. Anal sphincter manometry, a defecogram were performed on the patients before treatment, and the degree of severity of their fecal incontinence was recorded. All patients received transanal electrostimulation of the anal sphincter and a biofeedback therapy program. The total duration of the treatment program was four weeks. The level of symptom improvement, and the anal sphincter manometry and defecogram, were all reevaluated right after completed treatment in all patients. This study revealed an overall success rate of 85%, better than the individual success rates for transanal electrostimulation (62%) and biofeedback therapy alone (63%). This prospective study showed that a combination of transanal electrostimulation and biofeedback therapy is the most effective treatment for idiopathic anal incontinence.