INVOLUNTARY CONTRACTIONS OF THE STRIATED ANAL SPHINCTERS AS A CAUSE OF CONSTIPATION - REPORT OF A CASE

PATIENT HISTORY: We present a case of anismus in a 36-year-old patient . He complained of therapy refractory constipation that had been prese nt for 15 years, with delayed micturition and voiding by stages. METHO DS AND RESULTS: During digital examination of the anal canal, we found spontaneous contractions of the sphincters at rest. The urethral pres sure profile showed irregular contractions during micturition. The ele ctromyogram, which was performed with concentric needle electrodes fro m the external anal sphincter, puborectalis, and external vesical sphi ncter, revealed synchronous contractions of these muscles. Injections of botulinum toxin into the sphincters showed good effects and no inco ntinence. CONCLUSION: Focal dystonia of the striated anal and vesical sphincters is a very rare cause of constipation but should be included in the differential diagnosis.