The aim of the study is to determine the cutoff point for anal electrostimulation sensitivity as a prognostic value for clinical improvement in patients with defecatory dyssynergia (DD) treated with a multimodal approach. Additionally, the diagnostic accuracy and predictive value were assessed. The findings may contribute to the development of personalized treatment protocols that optimize patient selection and improve overall clinical outcomes.

This study was designed as an observational, descriptive, longitudinal, and retrospective analysis conducted in a specialized unit of a tertiary care hospital. The research focused on reviewing medical records of patients diagnosed with defecatory dyssynergia (DD) during the period from March to September 2024. This approach allowed for a retrospective evaluation of the relationship between anal electrostimulation sensitivity and clinical improvement in a controlled setting.

During the six-month analysis period, a total of 55 patients who met the established inclusion criteria were included. This study evaluates anal canal sensitivity through endocavitary electrostimulation as a prognostic marker for improvement in patients with DD undergoing multimodal rehabilitation. A total of 55 patients were included, employing a sensitivity threshold of 14 mA for the anal canal. While this threshold demonstrated limited sensitivity (66.7%), a higher value (20.5 mA) showed greater predictive capacity (87.5%). The findings support the use of anal sensitivity as a prognostic tool, highlighting the need for prospective studies to optimize its clinical application.

The population was predominantly female, representing 81.8% (n=45), while males accounted for 18.1% (n=10). The mean age was 56 years, ranging from 34 to 78 years. All included patients had a confirmed diagnosis of defecatory dyssynergia (DD) and had undergone treatment with anal electrostimulation and biofeedback (BFB) as part of their multimodal rehabilitation therapy.
To assess the discriminative ability of anal electrostimulation sensitivity as a predictor of clinical improvement, a receiver operating characteristic (ROC) curve analysis was performed. The area under the curve (AUC) was 0.951 (95% confidence interval: 0.89–1.0), demonstrating excellent capability in distinguishing between patients who experienced significant clinical improvement and those who did not after treatment.

This study supports the use of anal electrostimulation sensitivity as a valuable prognostic marker in patients with defecatory dyssynergia. The identified cutoff point (20.5 mAmp) demonstrates a high discriminative ability in predicting significant clinical improvement.

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