We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates t...

Muscular hypertrophy of the internal anal sphincter in association with proctalgia was first described a few years ago, but has remained largely unnoticed (1-4). In some cases autosomal-dominant inheritance has been demonstrated. Physical examination identifies an enlarged anal sphincter, which sometimes the patient has already noticed. This muscular mass may mimic an anal tumor and even hamper...

INTRODUCTION The aim of this review is to provide an overview of the use of biological materials in the augmentation of the anal sphincter either as part of an overlapping sphincter repair (OSR) or anal bulking procedure. METHODS A systematic search of PubMed was conducted using the search terms "anal bulking agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies us...

Anorectal manometry and sphincter electromyography were performed in 23 patients with complete supraconal traumatic spinal injuries and 30 age and sex matched control subjects. Basal pressures in the spinal group were similar to those in normal subjects but conscious control of sphincter activity was abolished in all spinal patients. Discriminant rectal sensation was also abolished during recta...

OBJECTIVE To describe the sonographic appearance of normal anal sphincter anatomy and sphincter defects evaluated with a conventional 5 MHz convex transducer placed on the perineum. DESIGN Prospective, single-blind study. SETTING Department of Obstetrics and Gynecology, University of Michigan Medical Center, USA. POPULATION Twenty-five women with symptoms of faecal incontinence, 11 asympt...

The relation between sensory perception of rapid balloon distension of the rectum and the motor responses of the rectum and external and internal anal sphincters in 27 normal subjects and 16 patients with faecal incontinence who had impaired rectal sensation but normal sphincter pressures was studied. In both patients and normal subjects, the onset and duration of rectal sensation correlated cl...