PURPOSE: To compare the effectiveness of biofeedback training (BF) with electrostimulation for patients with fecal incontinence. MATERIALS AND METHODS: Study of three therapeutic interventions consisting of BF daily for 4 wk (group 1) or BF daily for 4 wk, followed by a 2-mo home exercise program with BF (group 2) or electrostimulation daily for 3-mo (group 3). 40 patients with fecal incontinence were included. Measurements of fecal frequency, subjective improvement of incontinence and incontinence score were the main outcome measures at initial presentation, after 4 wk therapy program, and at follow-up after 3, 6, 12 mo. Standardized examination of manometric measurements were documented as secondary outcome measures. RESULTS: Group 1: the daytime fecal incontinence frequency decreased 71% after 4 wk of therapy and 42% after 12 mo (p = 0.001) from baseline. The continence score was reduced by 43% after 4 wk of therapy and 25% after 12 mo (p = 0.0001). Group 2: the daytime fecal incontinence frequency decreased 50% after 4 wk of therapy and 86% after 12 mo (p = 0.005) from baseline. The continence score was reduced by 10% after 4 wk of therapy and 30% after 12 mo (p = 0.006). Group 3: the daytime fecal incontinence frequency was reduced, but no statistically significant improvement. The continence score decreased 19% after 4 wk of therapy and 23% after 12 mo (p = 0.046). Results of manometric measurements showed statistically significant improvement in all variables in 3 groups after 3, 6, 12 mo. A comparison between the therapy groups did not reveal any significant differences. CONCLUSION: BF and electrostimulation are effective therapies for fecal incontinence and result in a significantly reduced fecal frequency and continence score. BF therapy resulted in a better subjective outcome and higher contraction pressures of the sphincter and pelvic-floor muscles.

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