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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2015

01-04-2015 | Review Article

Dutch evidence statement for pelvic physical therapy in patients with anal incontinence

Authors: L. C. M. Berghmans, J. A. M. Groot, I. C. van Heeswijk-Faase, E. M. J. Bols

Published in: International Urogynecology Journal | Issue 4/2015

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Abstract

Introduction and hypothesis

To promote agreement among and support the quality of pelvic physiotherapists’ skills and clinical reasoning in The Netherlands, an Evidence Statement Anal Incontinence (AI) was developed based on the practice-driven problem definitions outlined. We present a summary of the current state of knowledge and formulate recommendations for a methodical assessment and treatment for patients with AI, and place the evidence in a broader perspective of current developments.

Methods

Electronic literature searches were conducted in relevant databases with regard to prevalence, incidence, costs, etiological and prognostic factors, predictors of response to therapy, prevention, assessment, and treatment. The recommendations have been formulated on the basis of scientific evidence and where no evidence was available, recommendations were consensus-based.

Results

The evidence statement incorporates a practice statement with corresponding notes that clarify the recommendations, and accompanying flowcharts, describing the steps and recommendations with regard to the diagnostic and therapeutic process. The diagnostic process consists of history-taking and physical examination supported by measurement instruments. For each problem category for patients with AI, a certain treatment plan can be distinguished dependent on the presence of pelvic floor dysfunction, awareness of loss of stools, comorbidity, neurological problems, adequate anorectal sensation, and (in)voluntary control. Available evidence and expert opinion support the use of education, pelvic floor muscle training, biofeedback, and electrostimulation in selected patients.

Conclusions

The evidence statement reflects the current state of knowledge for a methodical and systematic physical therapeutic assessment and treatment for patients with AI.
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Metadata
Title
Dutch evidence statement for pelvic physical therapy in patients with anal incontinence
Authors
L. C. M. Berghmans
J. A. M. Groot
I. C. van Heeswijk-Faase
E. M. J. Bols
Publication date
01-04-2015
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 4/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-014-2555-y

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