Purpose
This study evaluated symptom severity and quality of life in patients with puborectalis dyssynergia before and after physical
therapy.
Methods
Twenty-two patients with puborectalis dyssynergia were prospectively enrolled into a multidisciplinary program for the treatment
of pelvic floor and bowel disorders in this case series. All patients had functional constipation and evidence of puborectalis
dyssynergia. Physical therapy and behavioral counseling were offered to all. Patients completed the Patient Health Questionnaire,
the Patient-Assessment of Constipation Symptom Questionnaire, and the Patient-Assessment of Constipation Quality of Life Questionnaire.
Results
Sixteen patients successfully completed the program. Symptom severity decreased after physical therapy (2.1 ± 0.7 vs. 1.3 ± 0.9, P = 0.007). Quality of life also improved significantly (2.6 ± 0.8 vs. 1.5 ± 1.0, P = 0.007). Patients reported less physical discomfort, fewer worries/concerns, and indicated satisfaction with treatment.
The difference in symptom severity was highly correlated with improvement in quality of life (r = 0.7, P = .005).
Conclusions
Successful physical therapy for patients with puborectalis dyssynergia is associated with improvements in constipation-related
symptoms and in quality of life.
Key words Constipation - Physical therapy - Quality of life
Presented at the American Urogynecologic Society Meeting, West Hollywood, Florida, September 27–29, 2007.