A pelvic floor muscle rehabilitation programme for pediatric patients undergoing colorectal surgery with sphincters involvement provides excellent results and more optimistic prognostic expectations.

INTRODUCTION

A high prevalence of patients operated on for Hirschsprung disease (HSCR) and Anorectal Malformations (ARM) may suffer from faecal incontinence. This prospective interventional study was aimed at assessing the possible benefits of paediatric pelvic floor muscle (PFM) rehabilitation in the treatment of such patients. MATERIALS AND

METHODS

All consecutive paediatric patients with HSCR and ARM complaining of continence issues admitted between January 2021 and December 2023 have been included. PFM rehabilitation was carried out with a therapist-patient ratio of 1:1. Patients were assessed with Wexner and Rintala scales at different timepoints (T0 enrolment, T1 after rehabilitation and T2 1 year post-rehabilitation).

RESULTS

A total of 49 patients (36 HSCR and 13 ARM) were enrolled. Median age was 10 years. Median Wexner score was 6 at T0, 5 at T1 and 2 at T2 with significant improvements both at T1 and T2. Median Rintala score was 11 at T0, 13 at T1, and 14 at T2 with significant improvements both at T1 and T2. The worse was the score at the beginning, the more evident was the improvement at subsequent timepoints. Similar results were achieved in HSCR and ARM. One third of patients using TAI at T0, reduced or abandoned it after PFM rehabilitation. DISCUSSION: This is the first prospective interventional study addressing PFM rehabilitation in paediatric patients after colorectal surgery. We demonstrated safety, tolerability, and effectiveness for both HSCR and ARM and demonstrated that effects last in the long-term reducing the likelihood of symptoms recurrence.