{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:35:49Z","timestamp":1785008149899,"version":"3.55.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In patients with Hirschsprung disease (HD), pelvic floor physical therapy (PFPT) is recommended for persistent incontinence or constipation refractory to other treatment, but there are no studies on utilization of PFPT. We aimed to assess clinical and sociodemographic factors associated with successful establishment of PFPT and outcomes following PFPT.<\/jats:p><jats:p>We performed a single-institution, retrospective chart review of patients with HD referred to PFPT between 2020 and 2023, involving both exercise and biofeedback. Data were collected on clinical factors, sociodemographics, and symptoms before and after PFPT. Those who \u201csaw PFPT,\u201d defined as at least one in-person appointment, were compared to those who did not see PFPT; symptoms were also compared. A p-value of 0.05 was considered significant.<\/jats:p><jats:p>There were 83 patients, of which 37 (44.6%) saw PFPT. There were no differences in age, transition zone, prior interventions, or symptoms. Half of the patients who saw PFPT only completed an initial visit; one-fifth completed the series. Most common reason for failure to see PFPT was scheduling issues. Patients who failed to see PFPT had financial stressors (42.5% vs. 16.1%, p\u2009=\u20090.02) and required formal support systems (28.2% vs. 3.3%, p\u2009=\u20090.02). In patients seeing PFPT, incontinence significantly improved (81.1% before vs. 40.5% after, p\u2009=\u20090.001).<\/jats:p><jats:p>Although PFPT is recommended in children with HD, those with financial stressors or scheduling issues may have barriers to access. However, those who see PFPT have improved symptoms. This suggests a need for improved accessibility of pediatric PFPT to children with HD, such as integration of PFPT into colorectal clinics.<\/jats:p>","DOI":"10.1055\/a-2536-4328","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T20:12:51Z","timestamp":1739304771000},"page":"295-301","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating Access and Efficacy of Pelvic Floor Physical Therapy in Pediatric Hirschsprung Disease"],"prefix":"10.1055","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6246-7843","authenticated-orcid":false,"given":"Shruthi","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Driesbach","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Su","sequence":"additional","affiliation":[{"name":"College of Medicine, The Ohio State University, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymin","family":"Bahhur","sequence":"additional","affiliation":[{"name":"College of Medicine, The Ohio State University, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Thomas","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Trimble","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Zahora","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Bergus","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra C.","family":"Gasior","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihab","family":"Halaweish","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Wood","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Center for Colorectal and Pelvic Reconstruction, Columbus, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s11894-021-00819-0","article-title":"Evaluation and management of persistent problems after surgery for Hirschsprung disease in a child","volume":"23","author":"H Ahmad","year":"2021","journal-title":"Curr Gastroenterol Rep"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"151164","DOI":"10.1016\/j.sempedsurg.2022.151164","article-title":"Evaluation and treatment of the post pull-through Hirschsprung patient who is not doing well; update for 2022","volume":"31","author":"H Ahmad","year":"2022","journal-title":"Semin Pediatr Surg"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1007\/s00383-017-4066-7","article-title":"Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease","volume":"33","author":"J C Langer","year":"2017","journal-title":"Pediatr Surg Int"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1055\/s-0032-1313351","article-title":"Efficacy of pelvic floor muscle training for the treatment of fecal incontinence after Soave procedure for Hirschsprung disease","volume":"22","author":"X Sun","year":"2012","journal-title":"Eur J Pediatr Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.cgh.2006.12.023","article-title":"Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation","volume":"5","author":"S SC Rao","year":"2007","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1159\/000500121","article-title":"Benefit of pelvic floor physical therapy in pediatric patients with dyssynergic defecation constipation","volume":"37","author":"C Zar-Kessler","year":"2019","journal-title":"Dig Dis"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1053\/j.gastro.2016.09.015","article-title":"Effectiveness of pelvic physiotherapy in children with functional constipation compared with standard medical care","volume":"152","author":"M L van Engelenburg-van Lonkhuyzen","year":"2017","journal-title":"Gastroenterology"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jpedsurg.2016.07.007","article-title":"A comparative study of transcutaneous interferential electrical stimulation plus behavioral therapy and behavioral therapy alone on constipation in postoperative Hirschsprung disease children","volume":"52","author":"S S Ladi-Seyedian","year":"2017","journal-title":"J Pediatr Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jpeds.2017.06.074","article-title":"Physical therapy for fecal incontinence in children with pelvic floor dyssynergia","volume":"190","author":"S Muddasani","year":"2017","journal-title":"J Pediatr"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"152.e1","DOI":"10.1016\/j.ajog.2011.03.029","article-title":"Barriers to pelvic floor physical therapy utilization for treatment of female urinary incontinence","volume":"205","author":"B B Washington","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1080\/09593985.2022.2143736","article-title":"The accessibility of pelvic health physiotherapy for adolescents with persistent pelvic pain: a qualitative framework analysis","volume":"40","author":"R Green","year":"2024","journal-title":"Physiother Theory Pract"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"101214","DOI":"10.1016\/j.cont.2024.101214","article-title":"Anorectal manometry\u2014how to perform and interpret manometry","volume":"10","author":"T Gala","year":"2024","journal-title":"Continence (Amst)"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1016\/j.jpedsurg.2022.12.032","article-title":"Speaking the same language in multi-center research: Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) updated colorectal definitions for 2022","volume":"58","author":"C A Smith","year":"2023","journal-title":"J Pediatr Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/S0022-5347(01)68065-0","article-title":"Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games","volume":"162","author":"P H McKenna","year":"1999","journal-title":"J Urol"},{"issue":"10","key":"ref16","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jpedsurg.2014.05.001","article-title":"Dyssynergic defecation may play an important role in postoperative Hirschsprung's disease patients with severe persistent constipation: analysis of a case series","volume":"49","author":"R J Meinds","year":"2014","journal-title":"J Pediatr Surg"},{"issue":"08","key":"ref17","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00383-019-04497-y","article-title":"Guidelines for the management of postoperative soiling in children with Hirschsprung disease","volume":"35","author":"P Saadai","year":"2019","journal-title":"Pediatr Surg Int"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00192-019-04090-w","article-title":"Better together: multidisciplinary approach improves adherence to pelvic floor physical therapy","volume":"31","author":"H W Brown","year":"2020","journal-title":"Int Urogynecol J"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1001\/archpedi.156.6.533","article-title":"A randomized, controlled trial of a community-based support program for families of children with chronic illness: pediatric outcomes","volume":"156","author":"R G Chernoff","year":"2002","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/fare.12183","article-title":"The impact of formal and informal support on health in the context of caregiving stress","volume":"65","author":"J P Gouin","year":"2016","journal-title":"Fam Relat"},{"issue":"S 02","key":"ref21","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1542\/peds.2016-2786E","article-title":"Partners for kids care coordination: lessons from the field","volume":"139","author":"R C Weier","year":"2017","journal-title":"Pediatrics"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/SPV.0000000000000401","article-title":"Barriers to pelvic floor physical therapy regarding treatment of high-tone pelvic floor dysfunction","volume":"23","author":"D Zoorob","year":"2017","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s11934-013-0358-1","article-title":"Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training","volume":"14","author":"K L Burgio","year":"2013","journal-title":"Curr Urol Rep"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.maturitas.2010.08.004","article-title":"Pelvic floor exercise for urinary incontinence: a systematic literature review","volume":"67","author":"N Price","year":"2010","journal-title":"Maturitas"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1055\/s-0034-1384662","article-title":"Pelvic floor rehabilitation in the treatment of fecal incontinence","volume":"27","author":"K M Scott","year":"2014","journal-title":"Clin Colon Rectal Surg"},{"issue":"12","key":"ref26","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1016\/j.jpedsurg.2017.08.043","article-title":"Quality of life outcomes in children with Hirschsprung disease","volume":"52","author":"L Collins","year":"2017","journal-title":"J Pediatr Surg"},{"issue":"07","key":"ref27","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1093\/ptj\/pzz050","article-title":"Factors associated with nonadherence to pelvic floor physical therapy referral for the treatment of pelvic pain in women","volume":"99","author":"F Aguirre","year":"2019","journal-title":"Phys Ther"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2536-4328.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T10:57:08Z","timestamp":1752231428000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2536-4328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,11]]},"references-count":26,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,7,10]]},"published-print":{"date-parts":[[2025,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2536-4328","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2,11]]},"published":{"date-parts":[[2025,2,11]]}}}