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Levator Ani Syndrome
Dis Colon Rectum 1997 Feb

Biofeedback is effective treatment for levator ani syndrome


Heah SM, Ho YH, Tan M, Leong AF
Department of Colorectal Surgery, Singapore General Hospital.
Purpose:
The effects of biofeedback (BF) on pain relief and anorectal physiology in patients with levator ani syndrome (LAS) were prospectively studied.
Method:
Sixteen consecutive patients (9 men, 7 women; mean age, 50.1 (range, 39-66) years) with LAS were treated with BF from July 1993 to October 1995. Mean duration of pain was 32.5 (standard error of the mean, 6.7) months. All underwent a full course of BF using a manometric balloon technique. Mean follow-up was 12.8 (standard error of the mean, 2.6) months. Pain score and anorectal physiology tests were administered prospectively by an independent observer before and after BF.
Results:
After BF, the pain score was significantly improved (before BF: median, 8 (range, 6-10); after BF: median, 2 (range, 1-4); P < 0.02). Analgesic requirements were also significantly reduced (all 16 patients needed nonsteroidal anti-inflammatory drugs (NSAID) before BF; only two patients needed NSAID after BF; P < 0.03). There were no significant changes to the anorectal physiology parameters after BF. To date, there have been no side effects or regressions.
Conclusion:
Although BF had a negligible effect on anorectal physiologic measurements in LAS, it was effective in pain relief, with no side effects.

Levator syndrome. A treatment that works.
Nicosia JF, Abcarian H
Forty-five patients with levator syndrome were treated by high voltage electrogalvanic stimulation of the levator ani by means of an intra-anal probe. Voltage varied from 150 to 400 volts, depending on patient tolerance. Negative electrodes and 80 cycles per second were used for 20 minutes every other day.
An average of five treatments was needed for complete pain relief. Excellent results (total pain relief) were obtained in 36 patients, good results in five, fair results in two, and poor results (no relief) in two.
High voltage electrogalvanic stimulation is the treatment of choice for levator syndrome because it can be standardized, is well tolerated, and is over 90 percent effective.
PMID: 3874049, UI: 85229880
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