The University of Southampton
University of Southampton Institutional Repository

The role of biofeedback in improving anal continence after anterior resection

Pilkington, Sophie A. (2010) The role of biofeedback in improving anal continence after anterior resection University of Southampton, School of Medicine, Doctoral Thesis , 281pp.

Record type: Thesis (Doctoral)


Incorporation of routine biofeedback into the management of patients with rectal cancer who are undergoing anterior resection offers potential for improved anal continence compared with standard management. A multicentre randomised controlled trial was performed to investigate this and 121 participants undergoing major rectal resection were randomly assigned to receive biofeedback training. In the control group participants received standard management. Randomisation was stratified for preoperative radiotherapy exposure. The primary end point was Cleveland Clinic Incontinence (CCI) score at 1 year. Analysis was by intention to treat (ITT). Secondary end points were serial symptom-score, quality of life questionnaires and anorectal physiology measured during the first postoperative year. Follow-up to one year was completed by 89 participants. A mean CCI score of 4 was recorded at 1 year in both groups. Before anterior resection, 15 (17%) participants reported severe anal incontinence. At 3 months after anterior resection, 27% of participants reported severe anal incontinence, which caused a negative impact on their quality of life. Function improved in some participants but 15% complained of severe anal incontinence at one year. Anal continence after anterior resection is a poorly defined problem. Although no advantage was found by the addition of routine biofeedback to standard management, this study establishes a working definition for “Anterior Resection Syndrome” and evaluates methods for measuring the structural and functional abnormalities associated with it. Symptom-score and quality of life questionnaires, anorectal physiology and proctography are frequently used to evaluate pelvic floor patients but are also relevant to assess anterior resection patients. An additional study was carried out to compare Barium (BaP) and MR proctography. BaP reproduced rectal emptying and demonstrated structural abnormalities to a greater extent than MR proctography and would be the best test for assessing structural abnormalities after anterior resection

PDF The_Role_of_Biofeedback_in_Improving_Anal_Continence_after_Anterior_Resection.pdf - Other
Download (16MB)

More information

Published date: August 2010
Organisations: University of Southampton, Cancer Sciences


Local EPrints ID: 196561
PURE UUID: a1fb0424-d8e1-4b01-9150-ad6168d4b535

Catalogue record

Date deposited: 09 Sep 2011 07:54
Last modified: 18 Jul 2017 11:22

Export record


Author: Sophie A. Pilkington
Thesis advisor: Karen Nugent

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.