Chiarioni Giuseppe, Chistolini Fabio, Menegotti Monica, Salandini Lara, Vantini Italo, Morelli Antonio, Bassotti Gabrio
Gastrointestinal Rehabilitation Division, Valeggio sul Mincio Hospital, Azienda Ospedaliera, University of Verona, Verona, Italy.
Dis Colon Rectum. 2004 Mar;47(3):346-53. doi: 10.1007/s10350-003-0047-1.
Constipation is a commonly reported symptom, and pelvic floor dyssynergia is frequently documented in constipated patients. The standard therapeutic approach for pelvic floor dyssynergia is biofeedback training, but long-term studies show that a significant percentage of patients remain symptomatic. Alternative or adjunctive therapeutic options are needed.
The purpose of this study was to evaluate the long-term effects of electrogalvanic stimulation in patients with pelvic floor dyssynergia and severe constipation, to see whether this treatment may be of some benefit.
Thirty consecutive constipated patients with clinical and instrumental evidence of pelvic floor dyssynergia entered the study and were treated with a standard high-frequency galvanic electrostimulation protocol. Clinical and instrumental (colon transit time, anorectal manometry, defecography, rectal balloon expulsion) assessment evaluations were performed basally and one year after the treatment.
Overall, approximately 50 percent of patients showed significant improvement after electrogalvanic treatment, from both a clinical and an instrumental point of view, as shown by the objective measurements obtained through manometry, defecography, and the balloon expulsion test. The benefit was limited to normal transit constipation patients.
Because of the relatively simple, painless and effective nature of electrogalvanic stimulation, we concluded that it may represent a useful adjunct to the therapeutic armamentarium for pelvic floor dyssynergia in normal transit constipation.
便秘是一种常见症状,盆底失协调在便秘患者中经常被记录到。盆底失协调的标准治疗方法是生物反馈训练,但长期研究表明,相当一部分患者仍有症状。需要其他治疗选择或辅助治疗方法。
本研究的目的是评估电刺激对盆底失协调和严重便秘患者的长期影响,以确定这种治疗是否有益。
连续30例有盆底失协调临床和仪器检查证据的便秘患者进入研究,接受标准的高频电刺激方案治疗。在治疗前和治疗一年后进行临床和仪器检查(结肠传输时间、肛门直肠测压、排粪造影、直肠气囊排出试验)评估。
总体而言,从临床和仪器检查角度来看,约50%的患者在接受电刺激治疗后有显著改善,这通过测压、排粪造影和气囊排出试验获得的客观测量结果得以体现。这种益处仅限于正常传输型便秘患者。
由于电刺激相对简单、无痛且有效,我们得出结论,它可能是正常传输型便秘盆底失协调治疗手段中的一种有用辅助方法。