Effect of Preoperative Biofeedback on Anal Continence After Fistula in Ano Surgery

Objective: The aim of the present prospective study was to evaluate the role of preoperative prophylactic biofeedback therapy on the anorectal continence of patients with high anal fistula who will be subjected to fistulectomy operation. Method: This was a randomized control study which included 40 patients who presented to the Out Patient Department (OPD) of Kasr‑al ainy Hospitals, from March 2015 to September 2016. Allpatients (40) have been presented with high complex anal fistulae. They were divided into two equal groups; group (A) has twenty patients who had undergone prophylactic preoperative anorectal biofeedback and group (B) has the other twenty patients who didn`t receive the prophylactic preoperative anorectal biofeedback therapy. For group (A) patients, six sessions of biofeedback were done two weeks. All patients were assessed postoperatively (0, 3 and 6 months) for continence by Cleveland Clinic Score for incontinence. Results: Among these forty patients only four (10%) had developed anal incontinence with variable degrees (two of them gas incontinence and another two developed frank stool incontinence), these four patients belong to the group (B), on the other hand, none of group (A) patients had developed incontinence. Conclusion: In conclusion, we can rely on preoperative prophylactic biofeedback has an important role to minimize incontinence post high anal fistula surgery.