COMPARATIVE STUDY BETWEEN BOTULINIUM TOXIN INJECTION AND PARTIAL DIVISION OF PUBORECTALIS FOR TREATING ANISMUS | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 26, Issue 4, October 2007, Page 169-175 PDF (163.79 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2007.371731 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Hesham A Moneim* ; Waleed Omar; Tarek Mahdy; Mohamed Farid | ||||
| Colorectal Surgery Unit, Mansoura University Hospital, Egypt | ||||
| Abstract | ||||
| Aim: to compare the results of partial division of puborectalis (PDPR) versus local botulinium toxin (BTX-A) injection in treating patients with anismus. Methods: this prospective randomized study included 30 male patients with a mean age 38.93 ± 12.39 years and a mean duration of 5.80 ± 3.96 years. Diagnosis was made by clinical examination, barium enema, colonoscopy, colonic transit time, anorectal manometry, balloon expulsion test, defecography, and EMG. Patients were randomized into: Group (I): included 15 patients injected with BTX-A, and Group (II): included 15 patients who underwent bilateral PDPR. Follow up was conducted for one year. Results: Both BTX-A and PDPR significantly reduced the preoperative constipation scores. The initial and long term success rates were 86.7% and 40% in BTX-A group versus 100% and 66.6% in PDPR group. Recurrence was observed in 7 patients (53.8%) and 5 patients (33.4%) following BTX-A and PDPR respectively. Minor incontinence had occurred in 2 patients (13.3%) following PDPR. Conclusion: BTX-A injection seems to be successful for temporary treatment of anismus. However, PDPR has been found to be a promising method for treatment of anismus with a relatively lower morbidity in relation to its higher success rate. | ||||
| Keywords | ||||
| Puborectalis syndrome; obstructed defecation; maladaptive constipation | ||||
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