Background Obstructed defaecation is a form of constipation, with fragmented stooling, excessive straining, self-digitation and a sense of incomplete emptying. Structured pelvic floor muscle training that identifies, promotes and reinforces correct muscle activity has been reported to assist these patients. Aims The aim of this study was to measure physiological effects and patient compliance of a goal-orientated pelvic floor muscle training program used to treat obstructed defaecation. Methods Female patients with obstructed defaecation referred to a tertiary hospital for anorectal physiology studies were identified. The patients underwent pre- and post- program anorectal examination including manometry, pudendal nerve terminal motor latency, and transvaginal and endoanal ultrasonography. Patients completed a structured physiotherapy program, and patient compliance and satisfaction were measured. Results Fifty-nine female patients were recruited to the study, mean age 60 years. Patient satisfaction with the programme was high (mean 8.488:SD 1.5; range 2-10). At completion of the program, KESS scores significantly decreased (12 ± 7) compared to baseline (15 ± 6), p .002 and the Oxford Grading Scale for pelvic floor strength showed a significant improvement (p=0.005). On rectal balloon distension the maximal tolerable volume showed a significant decrease from 180mL to 146mL (p .005). Conclusion This program demonstrated significant physiological improvements and high patient satisfaction. The observed reductions in KESS scores, changes in pelvic floor strength and rectal sensation indicate that this structured intervention effectively enhances anorectal function. Further research with larger, controlled studies is needed to confirm these findings and to optimise training protocols for broader clinical application.
Pieri et al. (Tue,) studied this question.