Sphincter sparing rectal resection surgery, either total mesorectal excision (TME) with a temporary loop ileostomy or partial mesorectal excision (PME), is the mainstay of rectal cancer treatment , however, these treatments are associated with the development of Low anterior resection syndrome (LARS). This syndrome is characterized by a constellation of symptoms such as fecal frequency, urgency and clustering of bowel movements and can lead to fecal and flatus incontinence. There is no gold standard therapy designed to treat the root cause of the problems associated with LARS. Paula Method of exercises, based on the theory that the body has the natural ability to self-heal and that all sphincter muscles in the body affect one another other and thus, exercising one healthy region can positively impact another. The purpose of this study is to evaluate the feasibility of the Paula Method of exercises in patients post sphincter sparing rectal resection surgery with LARS Syndrome.

Inclusion Criteria:

• Over age 18
• LARS syndrome (LARS score of 21 or higher) up to 24 months post sphincter sparing rectal resection
• Able to read, understand and communicate in Hebrew

Exclusion Criteria:

• Pregnancy
• Actively undergoing Chemotherapy or Radiation
• Other causes of anal incontinence or bowel dysfunction (ex: Irritable Bowel Syndrome)
• Concurrent performance of other exercise methods
• Unable or unwilling to perform the Paula exercises