Aim: The study was undertaken to determine outcome and to identify predictors of success of biofeedback 
for patients with spastic pelvic floor syndrome.
Patients & Methods: The study was done on 50 patients (35 females & 15 males) with a mean age of 30 ± 10 
years & a mean duration of constipation of 5 years. History, physical examination & barium enema excluded 
constipation secondary to organic causes. Then a series of tests of colonic & pelvic floor functions were 
performed before & after biofeedback treatment: colon- transit time, anorectal manometry ± EMG & 
defecography. Patients were treated on a weekly basis (average of 7 ± 2 sessions). Parameters included use of 
cathartics, number of spontaneous bowel movements per week, number of biofeedback sessions, results of 
anorectal physiology testing & patient satisfaction.
Results: The median number of spontaneous bowel movements per week before treatment was zero. Thirty 
five patients had complete success, 11 patients showed partial success and 4 patients had no improvement. 
Neither patient age, sex, symptom at initial assessment, nor duration of symptoms significantly affected 
outcome. Good indicators of success were ability to expel the balloon & to relax the pelvic floor early in the 
sessions. Also, the motivated patient who wants to continue the sessions, to cooperate & to spend time with 
the therapist was the most important predictive factor of success.
Conclusion: Biofeedback is an attractive treatment option as other therapies are associated with considerable
morbidity for patients with spastic pelvic floor syndrome.