COMPARATIVE STUDY BETWEEN BIOFEEDBACK RETRAINING AND BOTULINUM NEUROTOXIN IN TREATMENT OF ANISMUS PATIENTS | ||
The Egyptian Journal of Surgery | ||
Volume 27, Issue 3, July 2008, Pages 141-147 PDF (156.57 K) | ||
Document Type: Original Article | ||
DOI: 10.21608/ejsur.2008.371208 | ||
Authors | ||
Waled Omer; Ayman El Nakeeb* ; Amir Fikry; Hosam Ghazy; Sabry Ahmed; Elyamani Fouda; Mohamed Yousef; Hisham Abd El Monem; Wael Khafagy; Mosaad Morshed; Mohamed Farid | ||
Department of General Surgery, Colorectal Unit, Mansoura University Hospital, Egypt | ||
Abstract | ||
Aim: Anismus is a significant cause of chronic constipation. This study came to revive the results of biofeedback BFB retraining and botulinum toxin A BTX- A injection in treatment of anismus patients. Methods: Forty eight patients with history of constipation underwent anorectal manometry, balloon expulsion, defecography, and electromyography. All patients had a non relaxing puoborectalis muscle. The patients were randomized into 2 groups. Group I patients receive biofeedback, two times per week for one month. Group II patients were injected with BTX- A. Follow up was conducted weekly in the first month then monthly for one year. Results: In BFB training group 3 patients quite before the end of sessions with no improvement, initial improvement was recorded in 12 patients (50%) while long term success was recorded in 6 patients (25%). In BTX-A group, initial improvement recorded in 17 patients (70.83%) with long term improvement in 8 patients (33.3%) There is a significant difference between BTX-A group and BFB group as regarding the initial success, but this significant difference disappeared at the end of follow up. Conclusions: Biofeedback retraining has therapeutic effect on patients suffering from anismus also, BTX-A injection is successful for temporary treatment of anismus and need repeated injection. Initial improvement is better after BTX-A injection . | ||
Keywords | ||
Obstructed defecation; Constipation; Puborectalis | ||
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