Comparison study between electrogalvanic stimulation and local injection therapy in levator ani syndrome.
OBJECTIVE
Two theories have been reported for the pathophysiology of levator ani syndrome: the spastic cycle hypothesis and the local inflammation (Tendinitis) hypothesis. This study compared two treatment modalities in order to determine which of the two hypotheses is more appropriate.


METHODS
In this prospective study, Group EGS (n=22) underwent electrogalvanic stimulation twice a week. Group LI (n=31) underwent a local injection of a 40-mg triamcinolone acetonide mix with 1 ml 2% lidocaine into the maximal tender point of the arcus tendon in the levator ani muscle.


RESULTS
The most common location of tenderness was the left anterior of the arcus tendon of the levator ani muscle. At the last follow-up (12 months), the LI group showed more relief, more improvement, and fewer failures than the EGS group. No difference was seen between the mean pain scores (verbal analog scale: 0-100) of the two groups at either the 1-week or the 12-month follow-up. However, the LI group showed better results at the 1-month, 3-month, and 6-month follow-ups.


CONCLUSIONS
The LI group showed better short-term results than the EGS group. Therefore, the tendinitis hypothesis seems to be the more reliable one for levator ani syndrome. However, because the subjective responses of the patients indicated that a sufficient level of patient satisfaction had not been achieved, we cannot positively conclude that the tendinitis hypothesis is the more reliable one for the pathophysiology of levator ani syndrome.
Park
Duk-Hoon
DH
Department of Surgery, Song Do Medical Center, Seoul, South Korea. bear1213@unitel.co.kr
Yoon
Seo-Gue
SG
Kim
Kuhn Uk
KU
Hwang
Do Yeon
DY
Kim
Hyun Shig
HS
Lee
Jong Kyun
JK
Kim
Kwang Yun
KY
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001004:Anus Diseases / Q000628:therapy*; D004338:Drug Combinations; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
D000779:Anesthetics, Local; D004338:Drug Combinations; D005938:Glucocorticoids; D008012:Lidocaine; D014222:Triamcinolone Acetonide