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Pelvic floor rehabilitation for defecation disorders

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Abstract

Pelvic floor rehabilitation is frequently recommended for defecation disorders, in both constipation and fecal incontinence. However, the lack of patient selection, together with the variety of rehabilitation methods and protocols, often jeopardize the results of this approach, causing difficulty in evaluating outcomes and addressing proper management, and above all, in obtaining scientific evidence for the efficacy of these methods for specific indications. The authors represent different gastroenterological and surgical scientific societies in Italy, and their aim was to identify the indications and agree on treatment protocols for pelvic floor rehabilitation of patients with defecation disorders. This was achieved by means of a modified Delphi method, utilizing a working team (10 members) which developed the statements and a consensus group (15 members, different from the previous ones) which voted twice also suggesting modifications of the statements.

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Authors and Affiliations

  1. Gastroenterology Unit, Malatesta Novello Private Hospital, Cesena, Italy

    R. Bocchini

  2. RFF Division of Gastroenterology, University of Verona, Verona, Italy

    G. Chiarioni

  3. Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    G. Chiarioni

  4. Department of Gastroenterology, Istituto Clinico Humanitas, Milan, Italy

    E. Corazziari

  5. Department of Surgery and Translational Medicine, University of Florence, Florence, Italy

    F. Pucciani

  6. Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    F. Torresan

  7. Gastroenterology and Endoscopy Unit, San Luca Hospital, Lucca, Italy

    P. Alduini

  8. Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy

    G. Bassotti

  9. Gastroenterology and Endoscopy Unit, Cardinal Massaia Hospital, Asti, Italy

    E. Battaglia

  10. Endoscopy Unit, San Clemente Private Hospital, Mantua, Italy

    F. Ferrarini

  11. Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy

    F. Galeazzi

  12. Gastroenterology and Endoscopy Unit, ASST “Maggiore”, Crema, Cremona, Italy

    C. Londoni

  13. Gastroenterology Unit, S. Maria della Misericordia Hospital, Udine, Italy

    P. Rossitti

  14. Gastroenterology Unit, G. Brotzu Hospital, Cagliari, Italy

    P. Usai Satta

  15. Early Rehabilitation Department, S. Maria della Misericordia Hospital, Udine, Italy

    L. Iona

  16. Gastrointestinal Unit, Departmentt. of General Surgery, University of Pisa, Pisa, Italy

    S. Marchi

  17. U.O.Lungodegenza e Medicina, Ospedale Vittorio Emanuele III, Salemi, Tp, Italy

    G. Milazzo

  18. Department of Emergency and Organ Transplantation (DETO) and Interdepart mental Research Center for Pelvic Floor Dysfunction (CIRPAP), University Aldo Moro, Policlinico, Bari, Italy

    D. F. Altomare

  19. San Giuseppe Multimedica Hospital, Milan, Italy

    R. Barbera

  20. Gastroenterology and Endoscopy Unit, Department of Gastroenterology, A. Cardarelli Hospital, Naples, Italy

    A. Bove

  21. Gastroenterology Unit, SSVD Gastroenterologia, Ospedale SS Trinità, Borgomanero, No, Italy

    C. Calcara

  22. Gastroenterology and Digestive Endoscopy Unit, San Giovanni-Addolorata Hospital, Rome, Italy

    L. D’Alba

  23. Gastroenterology and Endoscopy Unit, Feltre Hospital, Feltre, Bl, Italy

    M. De Bona

  24. Gastroenterology and Endoscopy Unit, San Camillo-Forlanini Hospital, Rome, Italy

    F. Goffredo

  25. Department of Gastroenterology and Digestive Endoscopy, Crema Hospital, ASST CREMA, Crema, Italy

    G. Manfredi

  26. Proctological and Perineal Surgery Unit, Cisanello University Hospital, Pisa, Italy

    G. Naldini

  27. Gastroenterology Unit, Geriatric Institute “Pio Albergo Trivulzio”, Milan, Italy

    M. C. Neri

  28. Department of Digestive Physiopathology, Healte Center “Cittadella della Salute”, Lecce, Italy

    L. Turco

  29. Department of Surgical Sciences, University “La Sapienza”, Policlinico Umberto I, Rome, Italy

    F. La Torre

  30. Policlinico Morgagni, Catania, Italy

    A. P. D’Urso

  31. Rehabilitation Department, San Luca Hospital, Lucca, Italy

    I. Berni

  32. Proctological and Perineal Surgery Unit, Cisanello University Hospital, Pisa, Italy

    M. A. Balestri

  33. Rehabilitation Department, Villa Igea Private Hospital, Forlì, Italy

    N. Busin

  34. Early Rehabilitation Department, S. Maria della Misericordia Hospital, Udine, Italy

    C. Boemo

  35. Gastrointestinal Unit, Department of General Surgery, University of Pisa, Pisa, Italy

    M. Bellini

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  1. R. Bocchini
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  2. G. Chiarioni
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  7. G. Bassotti
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  13. P. Usai Satta
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  18. R. Barbera
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  30. I. Berni
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  31. M. A. Balestri
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  32. N. Busin
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  33. C. Boemo
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  34. M. Bellini
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Contributions

Authors and coauthors, Consensus members: All of them participated in study concept and design, data collection, provided critical revisions to manuscript drafts and approved the final version of the manuscript; therefore all should be regarded as collaborators for indexing purposes.

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Correspondence to R. Bocchini.

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As consensus review this paper does not contain any studies involving human participants performed by any of the authors.

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Bocchini, R., Chiarioni, G., Corazziari, E. et al. Pelvic floor rehabilitation for defecation disorders. Tech Coloproctol 23, 101–115 (2019). https://doi.org/10.1007/s10151-018-1921-z

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