Resultados de la de rehabilitación pelviperineal en pacientes con disinergia del suelo pélvico

Introduction: Pelvic floor dyssynergia (PPD) is a common cause of outlet obstruction constipation. Treatment for this condition is based on pelvi-perineal re-education (PPR). The aim of this study was to evaluate the results of PPR on patients with PPD. Methods: Patients with the diagnosis of PPD were included. The study was conducted between 2010 and 2011. PPR was performed by specialized kinesiologists. Prior and after treatment a constipation questionnaire was performed (KESS) (scale from 0 to 39 points, a higher score is associated with more symptom severity). KESS score before and after PPR were compared. Mann-Whitney-Wilcoxon rank sum test for paired samples was used for statistical analysis, p value <0,05 was considered as significant. Results: Thirteen patients were included (11 women), mean age 44.3 years old (r: 18-76). Mean total KESS score prior and after PPR were 19.6 (SD: 5.8) and 12.6 (DS: 63), respectively (P=.002).Frequency of bowel movements, stool consistency, abdominal pain and abdominal bloating did not present statistically significant changes before and after treatment. Use of laxatives, enemas and/or digitations, as well as unsuccessful evacuation, feelings of incomplete evacuation improved significantly. Total evacuation time (before 1.53 vs after 1; P=.012) and difficult evacuation causing painful efforts (before 2.08 vs after 1.07; P=.001) also decreased significantly. Conclusion: PPR in patients with PPD, significantly improves the symptoms of obstructive constipation, mainly with respect to mechanical assistance and difficult evacuation.