An introduction to rectal balloon expulsion tests in a pelvic floor clinic

Abstract

Biofeedback is a non-surgical treatment option for patients with pelvic floor symptoms, including faecal, flatus, urinary incontinence, obstructed defecation and evacuatory difficulties. A biofeedback therapist assesses the patient's pelvic floor muscle coordination and monitors their response to an inflated balloon acting as a simulated stool. Most patients attending the biofeedback clinic exhibit anorectal discoordination, which can be effectively corrected with rectal balloon expulsion exercise. Biofeedback therapy for pelvic floor dysynergic symptoms consists of biofeedback technique-guided pelvic floor relaxation, improving abdominal push effort, followed by simulated defecation and sensory training. This article discusses how to perform a rectal balloon expulsion test in a clinical setting by a trained therapist to improve clinical outcomes for pelvic floor dysfunction symptoms.