Pelvic Floor Physical Therapy for Complex Anorectal Dysfunction in a Male Patient: A Case Report
Lisa HotalingBackground:
Rectal prolapse with fecal incontinence is a debilitating affliction that is underreported because of shame and embarrassment. People suffering from this condition are often referred to pelvic floor physical therapy. Patient education combined with strengthening can help improve functional movement patterns and decrease symptoms of rectal prolapse; however, there is limited research informing specific physical therapy treatments for this condition.
Case Description:
The patient was a 35-year-old man with rectal prolapse, bleeding internal hemorrhoids, difficulty emptying the bowel fully, and fecal incontinence. Poor bowel habits, altered posture, and muscle weakness contributed to his symptoms. He was treated with strengthening exercises and patient education.
Outcomes:
Following 12 visits for more than 15 weeks, the patient demonstrated a 47-point improvement on the Pelvic Floor Impact Questionnaire-7, improvements in lumbar and hip mobility, core, and hip strength. His bowel frequency decreased from up to 10 bowel movements a day to 1. His Patient Specific Functional Scale score improved from 14 to 27.
Discussion:
This case report demonstrates the benefits of a conservative physical therapy treatment plan for symptom relief in a male patient with mild rectal prolapse, bleeding hemorrhoids, and fecal incontinence. Although surgery is often required, patients may benefit from physical therapy treatment prior to surgery to decrease severity of symptoms and improve postsurgical outcomes.
Informed Consent:
Informed consent was obtained. This case meets Health Insurance Portability and Accountability Act requirements for protected health information.