Author/Authors :
Outer, Waled Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , El Nakeeb, Ayman Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Fikry, Amir Mansoura University Hospital - Departments of General Surgery, Egypt , Ghazy, Hosam Mansoura University Hospital - Departments of General Surgery, Egypt , Ahmed, Sabry Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Fouda, Elyamani Mansoura University Hospital - Department of General surgery, Colorectal Unit, Egypt , Yousef, Mohamed Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Abd El Monem, Hisham Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Khafagy, Wael Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Morshed, Mosaad Mansoura University Hospital - Department of General Surgery, Colorectal Unit, Egypt , Farid, Mohamed Mansoura University Hospital - Departments of General Surgery, Colorectal Unit, Egypt
Abstract :
Aim: Anismus is a significant cause of chronic constipation. This study came to revive the results of biofeedback BFB retraining and botulinum toxin A BTX- A injection in treatment of anismus patients. Methods: Forty eight patients with history of constipation underwent anorectal manometry, balloon expulsion, defecography, and electromyography. All patients had a non relaxing puoborectalis muscle. The patients were randomized into 2 groups. Group I patients receive biofeedback, two times per week for one month. Group II patients were injected with BTX- A. Follow up was conducted weekly in the first month then monthly for one year. Results: In BFB training group 3 patients quite before the end of sessions with no improvement, initial improvement was recorded in 12 patients (50%) while long term success was recorded in 6 patients (25%). In BTX-A group, initial improvement recorded in 17 patients (70.83%) with long term improvement in 8 patients (33.3%) There is a significant difference between BTX-A group and BFB group as regarding the initial success, but this significant difference disappeared at the end of follow Conclusions: Biofeedback retraining has therapeutic effect on patients suffering from anismus also, BTX-A injection is successful for temporary treatment of anismus and need repeated injection. Initial improvement is better after BTX-A injection
