Danielle van Reijn-Baggen

Chapter 4 102 patients previously received PFPT. Most frequent indication for referral for PFPT was fecal incontinence in 27 patients (54%). Table 2. Patient characteristics. No. patients Gender Male, n (%) Female, n (%) 13 (27) 37 (74) Median age, years (SD) 51 (15) Indication, n (%) Fecal incontinence Obstructed defecation Chronic anal fissure Haemorrhoidal disease Other 27 (54) 10 (21) 3 (6) 2 (4) 8 (17) Vaginal parity, n (%) 0 1 2 >3 7 (19) 7 (19) 14 (38) 9 (24) Rectal surgery in the past, n (%) 9 (18) Radiotherapy in de past, n (%) 1 (2) Urologic or gynecologic surgery in the past, n (%) 10 (20) Neurological or connective tissue disease, n (%) 3 (6) Pelvic floor physical therapy in the past, n (%) 31 (62) Interrater agreement digital rectal examination The assessed sphincter tone and pelvic floor muscle function with DRE by the surgeon and the pelvic floor physical therapist during rest, squeeze and straining correlated in 78%, 78% and 84%, respectively. This resulted in substantial agreement for assessing the resting tone with a Cohen’s Weighted Kappa (κ) of 0.749 (95% CI 0.612-0.886). In the assessment of the squeeze tone this was somewhat lower, but still substantial, with a (κ) of 0.620 (95% CI 0.432-0.807). When assessing straining, they agreed almost perfect with a (κ) of 0.819 (95% CI 0.700-0.938). The prolonged squeeze (30 seconds) was only performed by few surgeons and therefore, we omitted this variable from the analysis. Digital rectal examination by the surgeon and pelvic floor physical therapist and anorectal manometry (n=46 and n=45) When classifying the resting tone and pressure as low, normal, or high, 23 (47%) patients were assessed similar by the surgeon’s DRE and the 3D-HRAM. In the assessment of squeeze tone and pressures this was somewhat better with 31 (65%)

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