title: Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training.
abstract: OBJECTIVE
  To evaluate the efficacy of botulinum toxin type A injection to the puborectalis and external sphincter muscle in the treatment of patients with anismus unresponsive to simple biofeedback training.
  
  
  METHODS
  This retrospective study included 31 patients suffering from anismus who were unresponsive to simple biofeedback training. Diagnosis was made by anorectal manometry, balloon expulsion test, surface electromyography of the pelvic floor muscle, and defecography. Patients were given botulinum toxin type A (BTX-A) injection and pelvic floor biofeedback training. Follow-up was conducted before the paper was written. Improvement was evaluated using the chronic constipation scoring system.
  
  
  RESULTS
  BTX-A injection combined with pelvic floor biofeedback training achieved success in 24 patients, with 23 maintaining persistent satisfaction during a mean period of 8.4 mo.
  
  
  CONCLUSIONS
  BTX-A injection combined with pelvic floor biofeedback training seems to be successful for intractable anismus.
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Zhen-Ning
authors.initials: ZN
authors.lastname: Wang
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: He
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Gao
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhai
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Zhi-Tao
authors.initials: ZT
authors.lastname: Yin
authors.affiliation: Yong Zhang, Lei He, Ge Gao, Qing Zhai, Zhi-Tao Yin, Xian-Dong Zeng, Department of Constipation and Pelvic Floor Disease, Constipation Treatment Center, Shenyang Coloproctology Hospital, Shenyang 110002, Liaoning Province, China.
authors.forename: Xian-Dong
authors.initials: XD
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D001676:Biofeedback, Psychology; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003248:Constipation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000187:drug effects*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D017773:Pelvic Floor / Q000503:physiopathology*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
keywords: Anismus; Biofeedback training; Constipation; Obstructed outlet constipation