ELECTROGALVANIC STIMULATION FOR LEVATOR-SYNDROME - HOW EFFECTIVE IS IT IN THE LONG-TERM

Levator syndrome is a symptom complex of severe pain and pressure in t he anorectal area. Electrogalvanic stimulation (EGS) has been proposed as a treatment for this condition. Several reports have described EGS as up to 90 percent 'effective'' in treating levator syndrome, but th e length of follow-up was uncertain or short-term in these studies. Th e purpose of this study was to examine the long-term benefits of EGS i n levator syndrome patients treated at one institution. All patients u ndergoing EGS for levator syndrome between 1985 and 1991 were studied. Initial complaints, physical examination, number of treatments, proce dure tolerance, and long-term benefit were determined through personal interviews and chart reviews. There were 52 patients (63 percent fema les and 37 percent males) with a median age of 54 years (range, 24-84 years). All patients presented with anorectal pain. Tenderness was loc alized by examination to the left in 43 percent, to the right in 23 pe rcent, and bilateral in 8.6 percent and was not localized in 2.6 perce nt. Fifty percent received fewer than four one-hour treatments. 3 perc ent received four to six treatments, and 17 percent received more than six treatments. Seventy-seven percent felt that the treatment was pai nless. Follow-up results were as follow: number, 5 2; percent folloW u p, 88; mean follow-up, 28 months (range. 0-71 months); symptoms reliev ed, 19 percent; partial relief, 24 percent; no relief, 57 percent. Of four patients with a wrong diagnosis. three were ultimately diagnosed with recurrent pelvic cancer and one had an anal fissure. At our insti tution, EGS was a tolerable treatment, but a substantial number of pat ients received no benefit. An organic etiology of anorectal pain must always be excluded.