All patients learned to relax external anal sphincter
during straining to defecate.
The term "anismus" is used to describe obstructed defecation that may be caused by inappropriate contraction or nonrelaxation of the pelvic floor, although its cause is unknown. Wasserman described a condition that he termed puborectalis syndrome, consisting of "a type of stenosis of anorectum caused by a spasm of a component of the external anal sphincter
muscle." This syndrome also is referred to as rectal dyschezia, paradoxical EAS, spastic pelvic floor syndrome, rectoanal dyssynergia, abdominoelevator incoordination, immobile perineum and abdominopelvic anachronism. The primary symptom reported by patients with anismus is obstructed defecation.
Use a 2-0 suture to repair the external anal sphincter
. Most obstetricians are familiar with the end-to-end repair.
This defect then extends into the internal and external anal sphincters
. It is a consistent finding in women with faecal incontinence due to anal sphincter disruption.
Fecal incontinence due to external anal sphincter
division in childbirth is associated with damage to the innervation of the pelvic floor musculature: a double pathology.
 where the author measured the age related variations in thickness of external anal sphincter
and puborectalis muscles in normal children.
Fused anteriorly to the posterior vaginal wall and attached laterally to the perineal membrane and bulbocavernosus and superficial transverse perineal muscles, a significant portion of what is clinically called the perineal body is actually the muscle of the external anal sphincter
. The strong upward traction of the levator ani muscles is much more important in maintaining vaginal outlet support than are the bulbocavernosus and superficial transverse perineal muscle.
Biofeedback therapy for chronic constipation is successful predominantly in the subset of patients who have outlet dysfunction-a paradoxical contraction of the external anal sphincter
(5) Recently, the important contribution of the external anal sphincter
for continence, has been stressed.
Until recently, defects of external anal sphincter
(EAS) were detected by electromyography and internal anal sphincter (IAS) by measurement of low resting anal pressure.
Then, each woman underwent concentric needle EMG of the external anal sphincter
. PNTML was not different among the three groups.
For years, restoration meant end-to-end external anal sphincter