International Journal of Colorectal Disease

, Volume 24, Issue 3, pp 327–334

Comparative study between botulinum toxin injection and partial division of puborectalis for treating anismus

  • Mohamed Farid
  • Tamer Youssef
  • Tarek Mahdy
  • Waleed Omar
  • Hesham Abdul Moneim
  • Ayman El_Nakeeb
  • Mohamed Youssef
Original Article

DOI: 10.1007/s00384-008-0609-7

Cite this article as:
Farid, M., Youssef, T., Mahdy, T. et al. Int J Colorectal Dis (2009) 24: 327. doi:10.1007/s00384-008-0609-7

Abstract

Objectives

The objective of this study was to compare the results of partial division of puborectalis (PDPR) versus local botulinum toxin type A (BTX-A) injection in treating patients with anismus.

Patients and methods

This prospective randomized study included 30 male patients suffering from anismus. Diagnosis was made by clinical examination, barium enema, colonoscopy, colonic transit time, anorectal manometry, balloon expulsion test, defecography, and electromyography. Patients were randomized into: group I which included 15 patients who were injected with BTX-A and group II which included 15 patients who underwent bilateral PDPR. Follow-up was conducted for about 1 year. Improvement was considered when patients returned to their normal habits.

Results

BTX-A injection achieved initial success in 13 patients (86.7%). However, long-term success persisted only in six patients (40%). This was in contrast to PDPR which achieved initial success in all patients (100%) with a long-term success in ten patients (66.6%). Recurrence was observed in seven patients (53.8%) and five patients (33.4%) following BTX-A injection and PDPR, respectively. Minor degrees of incontinence were confronted in two patients (13.3%) following PDPR.

Conclusion

BTX-A injection seems to be successful for temporary treatment of anismus.

Keywords

ConstipationAnismusPuborectalis syndromeObstructed defecation

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Mohamed Farid
    • 1
  • Tamer Youssef
    • 2
    • 3
  • Tarek Mahdy
    • 1
  • Waleed Omar
    • 1
  • Hesham Abdul Moneim
    • 1
  • Ayman El_Nakeeb
    • 1
  • Mohamed Youssef
    • 1
  1. 1.Mansoura Faculty of MedicineMansouraEgypt
  2. 2.Mansoura Faculty of MedicineMansoura University HospitalMansouraEgypt
  3. 3.Department of SurgeryMansoura University HospitalMansouraEgypt