Presented at the NVGE convention, 4th–6th October, 2017, Veldhoven, The Netherlands.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Anorectal pain is a symptom which may have both structural and functional causes, and can, sometimes, develop into a chronic pain syndrome. Functional causes in particular are challenging to treat when conservative treatment measures fail. Botulinum toxin A (BTX-A) can be applied to relax the anal sphincter and/or levator ani muscle to break the vicious circle of pain and contraction. In our tertiary referral proctology clinic, we evaluated the outcome of patients treated with BTX-A for chronic functional anorectal pain.
Our electronic database was searched for patients who had BTX-A treatment for chronic functional anorectal pain from 2011 to 2016. All medical data concerning history, treatments, and clinical outcome were retrieved. The clinical outcome (resolution of pain) was scored as good, temporary, or poor.
A total of 113 patients [47 (42%) males; age 51years, SD 13 years, range 18–88 years] with chronic functional anorectal pain were included. The outcome of BTX-A treatment was good in 53 (47%), temporary in 23 (20%), and poor in 37 (33%). To achieve this outcome, 29 (45%) patients needed a single treatment, 11 (44%) a second treatment, and 13 (54%) ≥ 3 treatments.
Chronic functional anorectal pain can be treated successfully with BTX-A in 47% of patients who fail conservative management. Repeated injections may be needed to ensure complete cure in a subgroup of patients.
Ploteau S, Labat JJ, Riant T, Levesque A, Robert R, Nizard J (2015) New concepts on functional chronic pelvic and perineal pain: pathophysiology and multidisciplinary management. Discov Med 19:185–192 PubMed
Drossman DA (2016) Functional Gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology 150:1262–1279 CrossRef
Rao SS, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A et al (2016) Functional anorectal disorders. Gastroenterology 130:1510–1518
Goschel H, Wohlfarth K, Frevert J, Dengler R, Bigalke H (1997) Botulinum A toxin therapy: neutralizing and nonneutralizing antibodies–therapeutic consequences. Exp Neurol 147:96–102 CrossRef
Voorham-van der Zalm PJ, Voorham JC, van den Bos TW, Ouwerkerk TJ, Putter H, Wasser MN et al (2013) Reliability and differentiation of pelvic floor muscle electromyography measurements in healthy volunteers using a new device: the Multiple Array Probe Leiden (MAPLe). Neurourol Urodyn 32:341–348 CrossRefPubMedPubMedCentral
- Botox treatment in patients with chronic functional anorectal pain: experiences of a tertiary referral proctology clinic
R. E. Ooijevaar
R. J. F. Felt-Bersma
I. J. Han-Geurts
D. van Reijn
P. F. Vollebregt
C. B. H. Molenaar
- Springer International Publishing
Neu im Fachgebiet Chirurgie
e.Med Kampagnen-Visual, Mail Icon II