The role of pelvic floor muscle training in the management of idiopathic fecal incontinence: a single-center prospective study.

INTRODUCTION

Fecal incontinence (FI) is a prevalent yet underreported condition that significantly impairs quality of life and social functioning. Conservative treatment, particularly pelvic floor muscle training (PFMT), plays a key role in patients with mild sphincter dysfunction or those not eligible for surgical intervention. However, the impact of professional supervision on the effectiveness of PFMT remains insufficiently explored.

METHODS

The study included 124 patients with fecal incontinence treated at a proctology department and 30 patients in the study control group (without fecal incontinence). The study group was divided into two groups: patients performing PFMT under physiotherapist supervision (n = 64) and patients exercising independently without professional supervision (n = 60). All participants underwent anorectal manometry and completed questionnaires assessing fecal incontinence severity using a modified Wexner scale before and after a 6-week exercise program. Resting and squeeze anal pressures were analyzed.

RESULTS

Before therapy, no statistically significant differences were observed between the groups. After completion of the rehabilitation program, patients exercising under physiotherapist supervision showed a significantly greater reduction in fecal incontinence-related lifestyle alterations than the unsupervised group. Supervised PFMT was associated with a significant improvement in functional outcomes, whereas no significant improvement was observed in patients exercising independently. In both groups, an increase in sphincter contraction pressure and improved retention of liquid stool were noted.

CONCLUSIONS

Pelvic floor muscle exercises are an effective conservative treatment for fecal incontinence; however, physiotherapist-supervised training yields superior clinical outcomes compared with unsupervised exercise. Professional supervision, appropriate patient qualification, and patient motivation are key factors influencing the success of pelvic floor rehabilitation.