Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training.
AIM
To evaluate the efficacy of botulinum toxin type A injection to the puborectalis and external sphincter muscle in the treatment of patients with anismus unresponsive to simple biofeedback training.


METHODS
This retrospective study included 31 patients suffering from anismus who were unresponsive to simple biofeedback training. Diagnosis was made by anorectal manometry, balloon expulsion test, surface electromyography of the pelvic floor muscle, and defecography. Patients were given botulinum toxin type A (BTX-A) injection and pelvic floor biofeedback training. Follow-up was conducted before the paper was written. Improvement was evaluated using the chronic constipation scoring system.


RESULTS
BTX-A injection combined with pelvic floor biofeedback training achieved success in 24 patients, with 23 maintaining persistent satisfaction during a mean period of 8.4 mo.


CONCLUSION
BTX-A injection combined with pelvic floor biofeedback training seems to be successful for intractable anismus.
['Zhang|Yong|Y|', 'Wang|Zhen-Ning|ZN|', 'He|Lei|L|', 'Gao|Ge|G|', 'Zhai|Qing|Q|', 'Yin|Zhi-Tao|ZT|', 'Zeng|Xian-Dong|XD|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001003:Anal Canal D001676:Biofeedback, Psychology D019274:Botulinum Toxins, Type A D002908:Chronic Disease D003131:Combined Modality Therapy D003248:Constipation D003672:Defecation D005260:Female D006801:Humans D007273:Injections, Intramuscular D008297:Male D008875:Middle Aged D009465:Neuromuscular Agents D017773:Pelvic Floor D020127:Recovery of Function D012189:Retrospective Studies D013997:Time Factors D017211:Treatment Failure D018084:Ultrasonography, Interventional D055815:Young Adult
Anismus Biofeedback training Constipation Obstructed outlet constipation