Botulinum-toxin-A injection following conservative management in patients with dyssynergic defaecation only improves symptoms in the short term: a retrospective study
J. coloproctol. (Rio J., Impr.)
; 44(1): 33-40, 2024. tab, ilus
Article
em En
| LILACS
| ID: biblio-1558288
Biblioteca responsável:
BR545.3
ABSTRACT
Objective:
Dyssynergic defaecation (DD) is an important cause of chronic constipation. In patients where conservative treatments fail, injections of botulinum toxin A (BTX-A) into the puborectalis and anal sphincter muscles can be effective. Complications of this procedure are reported to be rare and generally mild. This study aimed to identify the complication rates and short- to medium-term success rates of BTX-A injections as a treatment for DD.Methods:
A retrospective review was conducted on patients diagnosed with DD who had undergone BTX-A injections at a functional colorectal unit. Patient demographics, manometric assessment, conservative management, and injection technique were collected through a chart review. Subjective patient reports and comparison of pre- and postprocedure symptom scores were used to determine efficacy.Results:
The 21 patients included (24 procedures, with 3 patients receiving BTX-A on two separate occasions) all received stool modification and dietary advice, and 20 patients underwent pelvic floor physiotherapy, averaging 8 sessions. The injections were universally applied under general anesthetic, primarily targeting the anal sphincter and/or puborectalis muscles. There were 6 reports of faecal urge/incontinence, with all but one being resolved within weeks. The BTX-A injection was subjectively reported as beneficial in 19 cases, averaging 4.7 months (range 1-32) of improvement. Only 2 were sustained beyond 12 months. Despite overall improvements in symptom scores from pre- to postprocedure, none were statistically significant.Conclusion:
Following a course of conservative management, the BTX-A injection appears to be a safe treatment for DD, but only has short term efficacy. (AU)Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Toxinas Botulínicas Tipo A
/
Distúrbios do Assoalho Pélvico
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J. coloproctol. (Rio J., Impr.)
Assunto da revista:
Cirurgia
/
Doenas Retais
/
Doenas do Colo
/
GASTROENTEROLOGIA
/
Cirurgia
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Austrália
País de publicação:
Brasil