[Anorectal asynchronism. Clinical, manometric and therapeutic data].
OBJECTIVE
Anorectal asynchronism is a frequent and unrecognized cause of terminal constipation. The aim of this study was to describe clinical and instrumental findings, and results of biofeedback therapy.


METHODS
From 1987 to 1991, 18 patients with anorectal asynchronism were studied then treated by biofeedback training.


RESULTS
We found high rates of pelvic and perineal trauma (77.7%), of psychogenic factors (6.5%), of urinary incontinence (27.8%). The manometrical study confirmed puborectalis paradoxical contraction during defecation straining, and all the patients could not expel a rectal balloon containing 50 ml of air; non-specific manometrical abnormality was found in 44.5% patients. Excessive stamp of puborectalis muscle was always found at defecography; 77.7% of the patients had incomplete rectal evacuation, and 61.1% had an associated pelvic floor disorder. Biofeedback training was successful, and 88.9% of the patients were cured by 5 or 6 sessions. There was no predictive parameter in our study, but recovery rate seemed to be lower for patients from 45 to 55 years old.


CONCLUSIONS
The diagnosis of the anorectal asynchronism is easily made with manometry and defecography. Treatment with biofeedback gives very good results in almost all patients.
Service de Chirurgie générale et digestive, Hôpital Sainte-Marguerite, Marseille.
I
I
Sielezneff
J C
JC
Sarles
B
B
Sastre
D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D001676:Biofeedback, Psychology; D003248:Constipation / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors
Dyssynergie anorectale. Données cliniques, manométriques et thérapeutiques.