"Biofeedback has become an accepted treatment alternative for anal incontinence(96-101)." [Source: Wexner, S. Fundamentals of Anorectal Surgery, (New York: McGraw-Hill, 1992), p. 114. ]
"Biofeedback therapy for fecal incontinence was effective in treating children with surgical repair of imperforate anus." [Source: M. L. Allen, "Biofeedback for Fecally Incontinent Children With Repaired Imperforate Anus." Practical Gastroenterology, March, 1990 , 14:3, p. 53-62.]
"Biofeedback training appears to be of specific value in the treatment of fecal incontinence in the elderly. ... Sphincter exerises without biofeedback training were not effective. ... Biofeedback was also cost-effective." [Source: W.E. Whitehead, K.L. Burgio, B.T. Engel. "Biofeedback Treatment of Fecal Incontinence in Geriatric Patients" J Am Geriatrics Soc, May, 1985, 33:5, p. 320-325
"Biofeedback training of the external anal sphincter provides a simple nonmedical/nonsurgical approach to treatment." [Source: W.C. Orr, "Fecal Incontinence in the Elderly", Geriatric Medicine Today, May, 1988, 7:5, p. 126
"Intra-anal EMG sensor-type biofeedback may be more valuable than manometric-based training or simple Kegel exercises." [Source: Wexner, S. Fundamentals of Anorectal Surgery, (New York: McGraw-Hill, 1992), p. 114.]
"...there are many advantages to the [PerryMeterŞ] perineometer and electromyograph when it is compared to the balloon and polygraph system. ... It appears to be a reasonable assumption, therefore, that children will learn the appropriate response more quickly with the perineometer than with the polygraph." [Source: W.P. Lowery, W.E. Whitehead, Therapists Training Manual, n.d.]
"EGS may benefit some patients (43%)." "57% of patients in this study received no benefit after a mean follow-up time of 28 mos." [Source: T.L. Hull, J.W. Milson, J.M. Church, J.R. Oakley, I.C. Lavery, V.W. Fazio, Cleveland, OH. "Electrogalvanic Stimulation for Levator Syndrome: How Effective Is It In The Long Term?" [Poster, Am Soc Colon Rect Surg, June, 1992] (52 patients, Sohn's High voltage EGS protocol.)]
"Biofeedback management is an attractive alternative because of its relatively small expense and the absence of any known morbidity. This technique of training the mind to control comatic functions has been used successfully for treatment of other conditions, such as headaches, chronic pain, and fecal incontinence.13-15" [Source: J.J. Nogueras & S. D. Wexner. "Biofeedback for Nonrelaxing Puborectalis Syndrome" Seminars in Colon & Rectal Surgery, 3 (2) June, 1992, p. 120-124)]
"We concluded that simple verbal or written instruction does not represent adaquate preparation for a patient who is about to start a Kegel exercise program." [Source: R.C. Bump, W. G. Hurt, J.A. Fantl, J.F. Wyman. "Assesment of Kegel pelvic muscle exercise performance after brief verbal instruction." (Am J Obstet Gynecol 1991; 165:322-9)]
"I think the worst way to instruct patients is to ask them to interrupt the urinary stream repeatedly during micturition." [Source: R. C. Bump, "Assesment of Kegel pelvic muscle exercise performance after brief verbal instruction." (Am J Obstet Gynecol 1991; 165:322-9)]
"As a general rule, the least invasive therapy that is appropriate should be used first. That would mean, in many cases, behavioral and pharmacological treatments are tried first." [Source: Dr. Ananias C. Diokno, chair of AHCPR Panel on Incontinence, quoted at Press Conference, The New York Times, March 24, 1992.]
"The [AHCPR] guidelines suggest treatment should begin with the least invasive therapies: medication, bladder retraining and pelvic muscle exercises." Medical Panel Issues New Set of Guidelines. [Source:Wall Street Journal, March 24, 1992.]
"The panel...recommends noninvasive therapy-bladder training, pelvic muscle exercises, and treatment of transient causes of incontinence such as underlying infection-for most cases of UI." [Source: "New guideline on urinary incontinence released." Research Activities: Agency for Health Care Policy and Research, No. 152, April, 1992, p. 1.]
"...the non-binding guideline, to be issued March 23 by the U.S. Agency for Health Care Policy and Research, calls for doctors generally to use surgery as a last resort. It emphasizes informing patients about and using the full range of treatment options, including baldder retraining, pelvic muscle exercises and medication." [Source: Harris Meyer, "U.S. issues guideline on adult urinary incontinence", American Medical News, March, 1992.]
"The guideline recommends that surgery, except in very specific cases, should be considered only after behavioral and pharmacologic interventions have been tried. The panel outlines several surgical options and their risks for particular UI problems." [Source: AHCPR, Guidelines on Urinary Incontinence in Adults, (AHCPR, Rockville, MD, March 23, 1992), First Edition, p. xii. {As distributed to Members of Congress and to the Press. These sentences were later deleted from the edition circulated to the general public.}]