title: Involuntary contractions of the striated anal sphincters as a cause of constipation: report of a case.
abstract: METHODS
  We present a case of anismus in a 36-year-old patient. He complained of therapy refractory constipation that had been present for 15 years, with delayed micturition and voiding by stages.
  
  
  RESULTS
  During digital examination of the anal canal, we found spontaneous contractions of the sphincters at rest. The urethral pressure profile showed irregular contractions during micturition. The electromyogram, which was performed with concentric needle electrodes from the external anal sphincter, puborectalis, and external vesical sphincter, revealed synchronous contractions of these muscles. Injections of botulinum toxin into the sphincters showed good effects and no incontinence.
  
  
  CONCLUSIONS
  Focal dystonia of the striated anal and vesical sphincters is a very rare cause of constipation but should be included in the differential diagnosis.
authors.affiliation: Department of Neurology, German Diagnostic Clinic, Wiesbaden.
authors.forename: W H
authors.initials: WH
authors.lastname: Jost
authors.forename: H
authors.initials: H
authors.lastname: Müller-Lobeck
authors.forename: W
authors.initials: W
authors.lastname: Merkle
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000503:physiopathology*; D001905:Botulinum Toxins / Q000627:therapeutic use; D003248:Constipation / Q000188:drug therapy / Q000209:etiology*; D004576:Electromyography; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000502:physiology*
chemical_list: D001905:Botulinum Toxins