Physiotherapeutic Approaches to Treat Anal Incontinence in Women after Obstetric Trauma

• Published in: Journal of Coloproctology Vol. 42; no. 1; pp. 77 - 84
• Main Authors: Freitas, Mayanna Machado, Moura, Lara Elma Franco, Saquetto, Denise, Rodrigues, Iane Castro, Carvalho, Valéria Conceição Passos de, Uchôa, Silvana Maria Macedo
• Format: Journal Article
• Language: English
• Published: Thieme Revinter Publicações Ltda 01-03-2022
• Subjects: fecal incontinence; physiotherapy modalities; rehabilitation
• ISSN: 2237-9363; 2317-6423
• DOI: 10.1055/s-0042-1742621

Abstract
Introduction Anal incontinence is defined as the loss of voluntary control of fecal matter or gases with a recurrence period longer than 3 months in individuals aged ≥ 4 years; it has a female predominance. Among the treatment modalities is pelvic physiotherapy, the second line of treatment, which promotes the reeducation, coordination, and strengthening of the muscles of the pelvic floor to enable patients to return to their regular activities of daily living.
Objective To perform a systematic review on the physiotherapeutic treatments used in women between the ages of 18 and 65 years with a diagnosis of anal incontinence.
Material and methods Clinical studies written in Portuguese, Spanish and English were searched on the the following databases: Science Direct, Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and Scopus.
Results Of the 998 articles found, only 4 studies met the inclusion criteria of the present systematic review. The physiotherapeutic approaches to treat women with anal incontinence are biofeedback, Kegel exercises, electrostimulation, and training of the pelvic floor muscles. The average score on the PEDro scale was of 6.25, which indicates that the methodological quality was good.
Conclusion Although pelvic physiotherapy is effective to treat anal incontinence, it must be promoted through the performance of evidence-based scientific research.