Defecation is exquisitely painful, 'it's like passing razor blades', resulting in a cycle of fear of defecation, constipation, mucosal trauma and sphincter spasm
When the pain was uncontrolled, urethral sphincter spasm
made micturition difficult and there was also a blurring of my ability to interpret sensory messages from my pelvis.
The standard treatment is endoscopic retrograde cholangiopancreatography (ERCP), which allows complete documentation of the relevant anatomy, assessment of any sphincter spasm
by measuring the pressure with manometry, and immediate treatment by cutting the sphincter (sphincterotomy).