Botulin toxin in the treatment of nonrelaxing puborectalis syndrome.
OBJECTIVE
To evaluate the results of botulin toxin injection in the external anal sphincter for the treatment of nonrelaxing puborectalis syndrome.


METHODS
15 patients (13 women, 2 men; aged 36-48 years) were treated with botulinum A toxin injection, using a dose of 25 IU diluted in 1 ml normal saline injected into the top loop of the external anal sphincter at the 3 and 9 o'clock positions. The mean follow-up period was 14.6 +/- 3.3 (SD) months.


RESULTS
Two patients did not respond to the treatment while improvement occurred in 13. Straining at defecation disappeared and stool frequency was normalized. Improvement was maintained for a mean of 4. 8 +/- 1.4 SD months, after which time reinjection needed to be done. No adverse side effects were encountered.


CONCLUSIONS
Botulin toxin injection is a simple, easy and safe method for the treatment of nonrelaxing puborectalis syndrome. It is to be considered after biofeedback has failed.
Shafik
A
A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt.
El-Sibai
O
O
D000328:Adult; D001003:Anal Canal / Q000187:drug effects* / Q000503:physiopathology; D001905:Botulinum Toxins / Q000008:administration & dosage*; D003248:Constipation / Q000188:drug therapy / Q000209:etiology; D003672:Defecation / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000188:drug therapy* / Q000209:etiology; D013577:Syndrome
D001905:Botulinum Toxins