title: Comparative study between botulinum toxin injection and partial division of puborectalis for treating anismus.
abstract: OBJECTIVE
  The objective of this study was to compare the results of partial division of puborectalis (PDPR) versus local botulinum toxin type A (BTX-A) injection in treating patients with anismus.
  
  
  METHODS
  This prospective randomized study included 30 male patients suffering from anismus. Diagnosis was made by clinical examination, barium enema, colonoscopy, colonic transit time, anorectal manometry, balloon expulsion test, defecography, and electromyography. Patients were randomized into: group I which included 15 patients who were injected with BTX-A and group II which included 15 patients who underwent bilateral PDPR. Follow-up was conducted for about 1 year. Improvement was considered when patients returned to their normal habits.
  
  
  RESULTS
  BTX-A injection achieved initial success in 13 patients (86.7%). However, long-term success persisted only in six patients (40%). This was in contrast to PDPR which achieved initial success in all patients (100%) with a long-term success in ten patients (66.6%). Recurrence was observed in seven patients (53.8%) and five patients (33.4%) following BTX-A injection and PDPR, respectively. Minor degrees of incontinence were confronted in two patients (13.3%) following PDPR.
  
  
  CONCLUSIONS
  BTX-A injection seems to be successful for temporary treatment of anismus.
authors.affiliation: Mansoura Faculty of Medicine, Mansoura, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Farid
authors.forename: Tamer
authors.initials: T
authors.lastname: Youssef
authors.forename: Tarek
authors.initials: T
authors.lastname: Mahdy
authors.forename: Waleed
authors.initials: W
authors.lastname: Omar
authors.forename: Hesham Abdul
authors.initials: HA
authors.lastname: Moneim
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Mohamed
authors.initials: M
authors.lastname: Youssef
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000188:drug therapy* / Q000601:surgery*; D001905:Botulinum Toxins / Q000008:administration & dosage* / Q000627:therapeutic use*; D003248:Constipation; D003710:Demography; D006487:Hemostasis; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D013997:Time Factors
chemical_list: D001905:Botulinum Toxins