International Surgery Journal | October 2017 | Vol 4 | Issue 10 Page 3461 International Surgery Journal Porwal A et al. Int Surg J. 2017 Oct;4(10):3461-3465 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Biofeedback pelvic floor exercise therapy for pelvic floor dyssynergia: an observational study Ashwin Porwal 1 *, Paresh Gandhi 2 , Deepak Kulkarni 3 INTRODUCTION Constipation is a common disorder seen in family practice among the elderly and women. It affects nearly everyone in the general population at different points in their lifetime. Currently, constipation has a profound impact on adult patients’ quality of life and has been considered a major social and psychological disability. According to a survey the average population across the globe suffering from chronic constipation is around 10%. But as per Indian statistics it is about 14% of the Indians suffer from chronic constipation, higher than the world average. According to large scale epidemiological research by Talley et al, some of these patients can be managed with conservative treatments such as a high fiber diet, laxatives, suppositories, or oral polyethylene glycol, others are not sensitive to these options. Conservative medical treatment is ineffective in 39% of ABSTRACT Background: Pelvic floor dyssynergia (PFD) is one of the commonest subtypes of constipation and treated conservatively but is often unsatisfactory. Biofeedback Pelvic Floor Exercise Therapy (BFT) has been introduced as an alternative treatment. Method: A prospective study was conducted at Healing Hands Clinic, Pune. Total 35 patients diagnosed as having pelvic floor dyssynergia confirmed by MR defecography (MRD) enrolled in to the study. All patients trained for pelvic floor muscle exercise. Patient performed exercise 20 minutes per day for 12 weeks. Data have been collected using a standardized questionnaire (Longo's obstructed defecation syndrome (ODS) score, Patient Assessment of Constipation Quality of Life (PAC-QOL) and Bristol stool score and performed anal manomentry test (3-D HDAM) at every 4 weeks. Result: Study result demonstrated a statistically significant improvement in the mean resting pressure, maximum squeezing pressure and average of 10 seconds hold (from 69.83±6.40 to 39.87±5.51, 98.67±17.23 to 128.67±26.92, 78.70±15.41 to 109.00±22.23, P = 0.005 at week 12). The mean total ODS decreased significantly (p<0.0005) from baseline to 22.92±4.03 to 11.46±6.76 at week 12. Also, individuals ODS score items were significantly improved at week 8 and week 12. Bristol stool score significantly improved from 2.12±1.14 to 4.04±0.96 at 12 weeks (p<0.0005). Significant improvements were recorded in all four individual score domains (physical discomfort, psychosocial discomfort, worries and concerns, satisfaction) and total score of PAC-QOL at week 12. Conclusion: Biofeedback therapy provides improvement in bowel symptoms, anorectal function and reduces use of aperients in constipated subjects with pelvic floor dyssynergia Keywords: Anal manomentry, Behavioural therapy, Constipation, PFD, Quality of life, Resting pressure 1 Department of Colorectal Surgery, Healing Hands Clinic, Pune, Maharashtra, India 2 Department of Surgery, Healing Hands Clinic, Pune, Maharashtra, India 3 Department of Proctology and Enterology, Healing Hands Clinic, Pune, Maharashtra, India Received: 05 August 2017 Accepted: 02 September 2017 *Correspondence: Dr. Ashwin Porwal, E-mail: drashwinporwal@healinghandsclinic.co.in Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20174516