Current Situation on the Diagnosis of Anismus-Discordances Between Imaging and a Physiologic Study

Lee, Kyung Ha; Kim, Ji Yeon

doi:10.3393/ac.2016.32.5.159

Ann Coloproctol

2016

DOI: 10.3393/ac.2016.32.5.159

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Current Situation on the Diagnosis of Anismus-Discordances Between Imaging and a Physiologic Study

Kyung Ha Lee

Ji Yeon Kim

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2022

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“…Anismus, or pelvic floor dyssynergia, is a unique functional condition that entails failure of relaxation or paradoxical contraction of the puborectalis muscles (PRM) and external anal sphincter during defaecation [5]. This paradoxical reaction leads to persistent constipation due to failure to straighten the anorectal angle and shorten the anal canal, subsequently blocking the pathway of stool [6].…”

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Systematic review and meta‐analysis of the outcome of puborectalis division in the treatment of anismus

et al. 2022

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Aim Anismus is a common cause of obstructed defaecation syndrome (ODS). The aim of the present review is to assess the efficacy and safety of puborectalis muscle (PRM) division in the treatment of anismus. Method PubMed, Scopus, Web of Science and the Cochrane Library were searched for studies that assessed the outcome of PRM division in the treatment of anismus. The main outcome measures were subjective improvement in ODS, decrease in the Wexner constipation score and ODS score, and complications, namely faecal incontinence (FI). Results Ten studies (204 patients, 63.7% male) were included. The weighted mean rate of initial subjective improvement across randomized trials was 97.6% (95% CI 94%–100%) and across nonrandomized studies it was 63.1 (95% CI 39.3%–87%). The weighted mean rate of 12‐month improvement across randomized trials was 64.9% (95% CI 53.3%–76.4%) and across nonrandomized studies it was 55.9% (95% CI 30.8%–81%). The weighted mean rate of FI across randomized trials was 12.1% (95% CI 4.2%–20%) and across nonrandomized studies it was 10.4% (95% CI 1.6%–19.3%). Male sex and unilateral PRM division were significantly associated with recurrence of symptoms after PRM division. Bilateral PRM division, posterior division, complete division and concomitant sphincterotomy were significantly associated with FI after PRM division. Conclusions The use of PRM division for treatment of anismus was followed by some initial improvement in ODS symptoms which decreased to <60% 12 months after PRM division. The mean rate of FI after PRM division, namely 10%–12%, is a limitation of the technique. Further well‐designed trials are needed to verify the outcome of PRM division in the treatment of anismus.

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confidence: 99%

Systematic review and meta‐analysis of the outcome of puborectalis division in the treatment of anismus

et al. 2022

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Current Situation on the Diagnosis of Anismus-Discordances Between Imaging and a Physiologic Study

Cited by 1 publication

References 4 publications

Systematic review and meta‐analysis of the outcome of puborectalis division in the treatment of anismus

Systematic review and meta‐analysis of the outcome of puborectalis division in the treatment of anismus

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