Skip to main content

Anale Schmerzen

  • Chapter
Chirurgische Proktologie
  • 673 Accesses

Zusammenfassung

Das Krankheitsbild perianale Schmerzen ist nicht einheitlich definiert, häufig wird es auch als anorektal-perianale Neuralgie, Neuralgia pudendoanalis oder als paroxysmale Proktalgie bezeichnet. Die Ätiologie ist in vielen Fällen bis dato ungeklärt. Vor einer symptomatischen Therapie muss eine organbezogene Ursache ausgeschlossen werden. Aufgrund der Anatomie des Beckenbodens sollte gerade dieses Krankheitsbild interdisziplinär, d. h. in enger Kooperation von einem Proktologen, Urologen, Gynäkologen, Neurologen und Schmerztherapeuten behandelt werden. Nur mit einem exakt definierten Diagose- und Therapiepfad kann diesen haufig auserst schmerzgeplagten Patienten geholfen werden.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 239.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

Literatur zu Kap. 13.1

  1. Nisar PJ, Scholefield JH (2004) Casebook: anal pain. Practitioner 248: 312–319

    PubMed  Google Scholar 

  2. Bascom JU (1998) Pudendal canal syndrome and proctalgia fugax: a mechanism creating pain. Dis Colon Rectum 41: 406

    PubMed  CAS  Google Scholar 

  3. Potter MA, Bartolo DC (2001) Proctalgia fugax. Eur J Gastroenterol Hepatol 13: 1289–1290

    Article  PubMed  CAS  Google Scholar 

  4. Amarenco G, Lanoe Y, Ghnassia RT, Goudal H, Perrigot M (1988) Syndrome du canal d’Alcock et neuralgie perinéale. Rev Neurol 144: 523–526

    PubMed  CAS  Google Scholar 

  5. Shafik A (1991) Pudendal canal syndrome. Description of a new syndrome and its treatment. Report of seven cases. Coloproctology 13: 102–109

    Google Scholar 

  6. Jost WH, Schimrigk K (1994) Magnetic stimulation of the pudendal nerve. Dis Colon Rectum 37: 697–699

    PubMed  CAS  Google Scholar 

  7. Jost WH, Schimrigk K (1994) A new method to determine pudendal nerve motor latency and central motor conduction time to the external anal sphincter. Electroenceph Clin Neurophysiol 93: 237–239

    PubMed  CAS  Google Scholar 

  8. Jost WH, Duschka L (1997) Elektrisch stimulierte Pudenduslatenz. Coloproctology 19: 119–122

    Google Scholar 

  9. Jost WH, Duschka L, Herold A, Müller-Lobeck H, Stadelmaier U, Matzel KE (1999) Neurography of the pudendal nerve in pudendal canal syndrome. Dis Colon Rectum 42: 281–282

    PubMed  CAS  Google Scholar 

Literatur zu Kap. 13.2

  1. Albrektson B (1981) Sacral rhizotomy in cases of anococcygeal pain. Act Orthop Scand 52: 187–190

    Google Scholar 

  2. Bensaude A (1966) Proctalgies fugaces. Acta Gastro-Enterol Belg 28: 594–604

    Google Scholar 

  3. Boas RA (19981) Painfull anus syndrome. Pain Suppl 1: 259

    Google Scholar 

  4. Boquet I Moore N Lhuintre JP et al (1986) Diltiazem for proctalgia fugax. Lancet 28: 1043

    Google Scholar 

  5. Brom A (1992) Die Rolle von Magnesium und Kalzium bei Proctalgia fugax. Ak Koloprokt Edition Nymphenburg, München 8: 295–299

    Google Scholar 

  6. Delorme R (1900) Sur le Traitement des prolapses du rectum totaux pour l’excision de la muqueuse rectale ou rectocolique. Bull Mem Sc Chir Paris 26: 498

    Google Scholar 

  7. Dodi G, Spencer RJ (1996) Occult mucosal prolapse of the rectum and descending perineum syndrome. Outpatient Coloproctology Padova Piccin Nuova Libraria 3: 327–34

    Google Scholar 

  8. Eder M, Tilscher H (1985) Schmerzsyndrome der Wirbelsäule. Grundlagen, Diagnostik, Therapie. (3. Aufl) Hippokrates, Stuttgart

    Google Scholar 

  9. Eckardt VF, Doth O, Kanzler G, Berhard G (1996) Anorectal function and morphology in patients with sporadic proctalgia fugax. Dis Colon Rectum 39: 755–762

    Article  PubMed  CAS  Google Scholar 

  10. Ewing MR (1953) Proctalgia fugax. Br Med J 2: 1083–1085

    Google Scholar 

  11. Fischer M, Krismer M, Wimmer C, Stöckl B (1999) Kokkzygodynie. Coloproctology 21: 121–125

    Google Scholar 

  12. Grant SR, Salvati EP, Rubin RJ (1975) Levator syndrome: an analysis of 316 cases. Dis Colon Rectum 18: 161–163

    PubMed  CAS  Google Scholar 

  13. Girona J, Narro JL (1986) Chirurgische Behandlung des Descending-perineum-Syndroms. Ak Koloprokt Edition Nymphenburg, München 3: 57–64

    Google Scholar 

  14. Girona J (1997) Analer Schmerz bei Beckenbodeninsuffizienz-Differentialdiagnose. Ak Koloprokt Edition Nymphenburg, München 4: 190–202

    Google Scholar 

  15. Girona J (1989) Diagnostik des Descending-Perineum-Syndroms. Therapie des Descending-Perineum-Syndroms. Dtsch Med Wochenschr 114: 301–30

    PubMed  CAS  Google Scholar 

  16. Goligher JC (1980) Surgery of the anus, rectum and colon. Bailliere Tindall, London

    Google Scholar 

  17. Hanna M, Tilscher H (1987) Coccygodynie. Ak Koloprokt Edition Nymphenburg, München 4: 181–189

    Google Scholar 

  18. Henry MH, Parks AG, Swash M (1982) The pelvic floor musculature in the descending perineum syndrome. Br J Surg 69: 470

    PubMed  CAS  Google Scholar 

  19. Henry MM, Swash M (1992) Chronic perianal pain syndromes. In: Coloproctology and the pelvic floor, 2nd edn, pp 448–454

    Google Scholar 

  20. Hodge J (1979) Clinical management of coccygodynia. Med Trial Tech Quarterly 25: 277

    CAS  Google Scholar 

  21. Ibrahim M (1961) Proctalgia fugax. GUT 2: 137–140

    PubMed  CAS  Google Scholar 

  22. Kennedy HL (1993) Rectal prolaps: perineal approach (Delorme operation). In: Fielding LP Goldberg SM (eds) Surgery of the colon, rectum and anus. Butterworth-Heinemann, Oxfort, London, Boston: 721–725

    Google Scholar 

  23. Knoch HG (1992) Das Descending Perineum Syndrom (DPS). Hautnah 6: 634

    Google Scholar 

  24. Kraemer M, Schneider J, Thiede A (1992) Diagnostik der Beckenbodeninsuffizienz. Dtsch Med Wochenschr: 827.830

    Google Scholar 

  25. Lowenstein B, Cataldo PA (1998) Treatment of proctalgia fugax with topical nitroglycerin: report of a case. Dis Colon Rectum 41: 667–668

    Article  PubMed  CAS  Google Scholar 

  26. Myrtle AS (1883) Some common affections of the anus. Br Med J 1: 1061

    Google Scholar 

  27. Neill ME, Swash M (1982) Chronic perianal pain: an unsolved problem. J R Soc Med 75: 96–101

    PubMed  CAS  Google Scholar 

  28. Parks AG, Porter NH, Hardcastle JD (1966) The syndrome of the descending perineum. Proc R Soc Med 59: 477–482

    PubMed  CAS  Google Scholar 

  29. Percy JP, Neill ME, Parks AG Swash M (1981) Electrophysiological study of motor nerve supply of pelvic floor. Lancet i: 16–17

    Google Scholar 

  30. Pilling LF, Wendell MS, Swenson PhD et al. (1965) The psychologic aspects of proctalgia fugax. Dis Colon Rectum 21: 393–396

    Google Scholar 

  31. Simpson JY (1959) Coccygodynia and diseases and deformities of the coccyx. Med Times Gazette 40: 1009–1010

    Google Scholar 

  32. Shafik A (1993) Constipation. Pathogenesis and management. Drugs 45: 528–540

    PubMed  CAS  Google Scholar 

  33. Shafik A (2001) Magnetic pudendal neurostimulation: a novel method for measuring pudendal nerve terminal motor latency. Clin Neurophysiol 6: 1049–1053

    Google Scholar 

  34. Snooks SJ, Croft RJ (1998) Defaecation claudication: a cause of rectal pain? J R Soc Med 82: 371–372

    Google Scholar 

  35. Stelzner F (1994) Über die Ursache und die Therapie des Mastdarmvorfalls. Chirurg 65: 533

    PubMed  CAS  Google Scholar 

  36. Struppler A, Hiell P (1997) Schmerz und Schmerzbehandlung heute. Fischer, Stuttgart

    Google Scholar 

  37. Swash M, Forster JMG (1992) Chronic perianal pain syndromes. In: Henry MM, Swash M (eds) Coloproctology and the pelvic floor. Butterworth, London: 449–454

    Google Scholar 

  38. Thaysen Theh (1935) Proctalgia fugax. Lancet ii: 243–246

    Google Scholar 

  39. Thiede A, Kraemer M Fuchs K-H (1997) Beckenbodeninsuffizienz. In: Gastrointestinale Funktionsstörungen. Springer, Berlin Heidelberg New York, S 856–892

    Google Scholar 

  40. Thiele GH (1963) Coccygodynia: cause and treatment. Dis Colon Rectum 6: 422–436

    Google Scholar 

  41. Thomas E (1989) Ist die Proctalgia fugax ein selbständiges Krankheitsbild? Ak Koloprokt Edition Nymphenburg, München 6: 128–133

    Google Scholar 

  42. Thomson WG (1984) Proctalgia fugax. Am J Gastroent 79: 450–452

    Google Scholar 

  43. Vaccaro CA, Cheong DMO, Wexner SD et al. (1955) Pudendal neuropathy in evacuatory disorders. Dis Colon Rectum 38: 166

    Google Scholar 

  44. Wienert V (1987) Proctalgia fugax. Ak Koloprok Edition Nymphenburg, München 4: 177–180

    Google Scholar 

  45. Winkler R (1991) Beckenbodeninsuffizienz. Leber Magen Darm 21: 99

    PubMed  CAS  Google Scholar 

Literatur zu Kap. 13.3

  1. Schnitzer B (1965) Ectopic ureteral opening into seminal vesicle: a report of four cases. J Urol 93: 576

    PubMed  CAS  Google Scholar 

  2. Russo P (2000) Urologic emergencies in the cancer patient. Semin Oncol 27(3): 284–298

    PubMed  CAS  Google Scholar 

  3. Machtens SA, Kuczyk MA, Becker AJ, Stief CG, Jonas U (1998) Partial unilateral penile thrombosis: magnetic resonance imaging and management. J Urol 160(2): 494–495

    Article  PubMed  CAS  Google Scholar 

Literatur zu Kap. 13.4

  1. Shafik A, El-Sherif M, Youssef A, El-Sibai O. Surgical anatomy of the pudendal nerve and its clinical implications. Clin Anat 1995, 8: 110–115

    Article  PubMed  CAS  Google Scholar 

  2. Shafik A. Doss S. Pudendal canal. Surgical anatomy and clinical implication. Am Surg 1999, 56: 176–180

    Google Scholar 

  3. Shafik A. Pudendal canal syndrome. Description of a new syndrome and its treatment. Report of seven cases. Coloproctology 1991, 13: 102–109

    Google Scholar 

  4. Shafik A. Strainodynia: An etiopathologic study. J Clin Gastroenterol 1988, 10: 179–184

    PubMed  CAS  Google Scholar 

  5. Shafik A. Pudendal canal decompression in the treatment of idiopathic fecal incontinence. Dig Surg 1992, 9: 265–271

    Google Scholar 

  6. Shafik A. Pudendal canal decompression in the treatment of urinary stress incontinence. Int Urogynecol J 1994, 5: 215–220

    Google Scholar 

  7. Shafik A. Pudendal canal decompression in the treatment of erectile dysfunction. Arch Andrology 1994, 32: 141–149

    CAS  Google Scholar 

  8. Shafik A. Chronic scrotalgia: Report of four cases with successful treatment. Pain Digest 1993, 3: 252–256

    Google Scholar 

  9. Shafik A. Pudendal canal syndrome as a cause of vulvodynia and its treatment by pudendal nerve decompression. Eur J Obstet Gyn Reprod Biol 1998, 80: 215–220

    CAS  Google Scholar 

  10. Shafik A. Pudendal canal syndrome: A new etiological factor in prostatodynia and its treatment by pudendal canal decompression. Pain Digest 1998, 8: 32–36

    Google Scholar 

  11. Shafik A. Pudendal artery syndrome with erectile dysfunction: Treatment by pudendal canal decompression. Arch Androl 1995, 34: 83–94.

    PubMed  CAS  Google Scholar 

  12. Shafik A. Pudendal artery syndrome presenting as ischemic proctitis. Report of 3 cases. Dig Surg 1996, 13: 53–58

    Google Scholar 

  13. Shafik A. The levator dysfunction syndrome. A new syndrome with report of seven cases. Coloproctology 1983, 5: 158–165

    Google Scholar 

  14. Shafik A. The posterior approach in the treatment of pudendal canal syndrome. Coloproctology 1992, 14: 310–315

    Google Scholar 

  15. Shafik A. Endoscopic pudendal canal decompression for the treatment of fecal incontinence due to pudendal canal syndrome. J Laparoendosc Adv Surg Techn 1997, 7, 227–234

    CAS  Google Scholar 

  16. Matzel KE, Schmidt RA, Tanagho EA (1990) Neuroanatomy of the striated muscular anal continence mechanism — Implications for the use of neurostimulation, Dis Colon Rectum 33: 666–673

    Article  PubMed  CAS  Google Scholar 

Download references

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer Medizin Verlag Heidelberg

About this chapter

Cite this chapter

(2006). Anale Schmerzen. In: Chirurgische Proktologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-29037-0_13

Download citation

  • DOI: https://doi.org/10.1007/3-540-29037-0_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-20030-7

  • Online ISBN: 978-3-540-29037-7

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics