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Published in: International Journal of Colorectal Disease 3/2009

01-03-2009 | Original Article

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

Authors: Mohamed Farid, Tamer Youssef, Tarek Mahdy, Waleed Omar, Hesham Abdul Moneim, Ayman El_Nakeeb, Mohamed Youssef

Published in: International Journal of Colorectal Disease | Issue 3/2009

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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.
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Metadata
Title
Comparative study between botulinum toxin injection and partial division of puborectalis for treating anismus
Authors
Mohamed Farid
Tamer Youssef
Tarek Mahdy
Waleed Omar
Hesham Abdul Moneim
Ayman El_Nakeeb
Mohamed Youssef
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 3/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-008-0609-7

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