Sacral magnetic stimulation in paradoxical puborectalis syndrome

Background/Purpose: Our earlier studies have demonstrated that sacral magne tic stimulation (MS) in the canine model, in healthy volunteers and in cons tipated subjects brought about a rise in rectal pressure and a decline in r ectal neck (anal canal) pressure as well as rectal evacuation. Based on the se results, we studied the effect of sacral MS on defecation in patients wi th paradoxical puborectalis syndrome (PPS). Methods: Eleven subjects (8 wom en, 3 men; age 36-53 years) with PPS were enrolled in the study. The magnet ic coil was placed on the back with its center located between L4 and L5. S timulation parameters were set at 70% of maximum intensity, 40 Hz frequency and 2 s burst length with 2 s off. During MS, the rectal neck and gastric (intra-abdominal) pressures were measured. The procedure was performed in t he empty and the full rectum using the balloon expulsion test in the latter . Results: MS of the empty and balloon-filled rectum brought about a rise i n the rectal pressure (p < 0.001), decline in rectal neck pressure (p < 0.0 01) and no significant change in intragastric pressure (p > 0.05). The ball oon was expelled by all patients. Conclusions: Sacral MS succeeded in expel ling the water-filled rectal balloon. The method is simple, easy, noninvasi ve, nonradiologic and can be performed on an outpatient basis in the treatm ent of PPS. Copyright (C) 2000 S. Karger AG, Basel.