Lateral division of the puborectalis muscle in the management of severe constipation.
MA Kamm, PR Hawley, JE Lennard-Jones
Br J Surg | Published : 1988
Patients with severe constipation often do not 'relax' their pelvic floor during defaecation. Electromyography of the pelvic floor may reveal inappropriate contraction during defaecation straining, and balloon expulsion, a test of rectal evacuation, may be impaired. Fifteen patients with severe idiopathic constipation and three patients with a megarectum underwent lateral division of the puborectalis muscle and upper half of the external sphincter muscle. Twelve patients had a unilateral division and six patients had both sides divided. Surgery caused a marked reduction in the maximum voluntary squeeze pressure in the anal canal from a pre-operative mean of 90 +/- 49 (s.d.) cmH2O to a postop..View full abstract