Targeted Electromyographic Biofeedback With Endoanal Electrostimulation for Anal Incontinence

• Published in: Surgical innovation Vol. 30; no. 1; p. 56
• Main Authors: Martín Prieto, L, Pascual Migueláñez, I, Fernández Cebrián, J M, Martínez Puente, M C, Varillas-Delgado, D, Fernández Rodríguez, M, Pascual Montero, J A
• Format: Journal Article
• Language: English
• Published: United States 01.02.2023
• Subjects: Anal Canal; Biofeedback, Psychology - methods; Electric Stimulation Therapy - methods; Electromyography - methods; Fecal Incontinence; Humans; Manometry; Quality of Life; Treatment Outcome; biofeedback and endoanal electrostimulation; multiple array probe leiden novuqare; anal incontinence; electromyography
• ISSN: 1553-3514
• DOI: 10.1177/15533506221096885

. Anal incontinence (AI) is a disabling condition with a variable response to conservative physical therapies. We assess the utility of combining electromyographic biofeedback with endoanal electrostimulation targeted to the weakest areas of the pelvic floor using the MAPLe probe (Multiple Array Probe Leiden Novuqare). . Patients with AI unresponsive to conservative measures were assessed before and after treatment with anorectal manometry (ARM), electromyography (EMG), Wexner Continence Scoring, Visual Analog Scoring (VAS), FIQL and SF-12 quality of life determination. . Of 29 patients in the final analysis, there was an improvement in the mean Wexner continence score from 13.59 to 8.03 and a concomitant improvement in the reported VAS from 3.45 to 6.72. Both Wexner continence and VAS scores were maintained during follow-up. Maximum voluntary manometric contraction significantly improved from 91.76 mmHg to 110.33 mmHg with no changes in resting pressure. The EMG values ​​(μV) that significantly improved included the average and peak resistance, the average general voluntary contraction, and the average and peak voluntary contraction for both the external anal sphincter and the puborectalis. In the FIQL, behavior, depression and shame domains improved after treatment and during follow-up with lifestyle improvements detected at 6 and 12 months. Physical and mental components of the SF-12 improved at 6 and 12 months. . Targeted electromyographic biofeedback and endoanal electrostimulation using MAPLe® probe in AI patients sustainably improves objective ARM and EMG parameters along with subjective reporting of continence severity, VAS, and quality of life.