Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training

Table 2 Anorectal manometry parameter, balloon expulsion test results, and constipation scoring system before and after botulinum toxin type A injection and consecutive pelvic biofeedback training

	Pre-BTX-A injection	Post-BTX-A injection and consecutive biofeedback training	t	P
Pressure of rectum during defecation (mmHg)	64 ± 27	67 ± 28	1.335	0.192
Rest pressure of anal canal (mmHg)	93 ± 16.5	63 ± 8.6.3	11.726	0.000
Pressure of anal canal during defecation (mmHg)	105 ± 28.3	42 ± 8.9	12.328	0.000
Functional length of anal sphincter (cm)	4.5 ± 0.84	3.2 ± 0.54	8.9	0.000
Balloon expulsion test success rate	0%	74.2% (23/31)	9.185	0.002
Chronic constipation score	14.3 ± 2.49	6.4 ± 3.20	14.108	0.000

The BTX-A injection obviously improved the dilemma of animus treatment. We found that BTX-A injection produced an instant result to decrease resistance during defecation. The constipation scoring system (CSS) questionnaire was used after the injection. We found that BTX-A injection followed by pelvic biofeedback training significantly improved difficult defecation. According to the results of the CSS evaluation, patients were significantly improved in all symptom aspects mentioned in the CSS. BTX-A: Botulinum toxin type A.