COMPARATIVE STUDY BETWEEN OPEN VS CLOSED METHODS OF PARTIAL DIVISION OF PUBORECTALIS IN TREATING PATIENTS WITH ANISMUS | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 26, Issue 1, January 2007, Page 17-23 PDF (343.05 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2007.372328 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohamed Farid; Hesham Abdul Moneim* ; Waleed Omar; Mohamed Youssef | ||||
| Colorectal Surgery Unit, Mansoura University Hospital, Egypt | ||||
| Abstract | ||||
| Aim: to revive the results of partial division of the puborectalis and to compare the efficacy of open and a newly designed closed method in treatment of anismus. Methods: This prospective randomized study included 30 patients. They were 29 males and one female, with a mean age 42.30± 13.01 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 who underwent Bilateral open division of the puborectalis and Group (II): included 15 patients who underwent Bilateral closed method. Follow up was conducted for about one year. Improvement was considered when patients returned to their normal habits. Results: Both open and closed methods significantly reduced the preoperative constipation scores. There was 100% initial success. Long term success existed only in 66.6% and 53.3% in group (I) & (II) respectively with no significant difference between the two methods (χ2:0.556 - P: 0.456). Recurrence was observed in 5 and 7 patients following open and closed methods respectively. Minor degrees of incontinence were confronted in 13.3% in each group with no significant difference. Conclusion: Bilateral partial division of puborectalis was found to be an effective method in treatment of anismus. Moreover, closed method seems to be simple and attractive. | ||||
| Keywords | ||||
| puborectalis syndrome; obstructed defecation; maladaptive constipation | ||||
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