All patients learned to relax external anal sphincter during straining to defecate.
Using EMG-biofeedback, the patients learned to relax external anal sphincter to permit defecation, decreasing significantly the anismus index.
In normal patients, any action that increases intra-abdominal pressure -- such as sneezing, coughing, rising from a chair, walking and even talking -- is always accompanied by compensatory increases in the activity of the external anal sphincter and puborectalis muscles.
Paradoxical external anal sphincter function in fecal retention with soiling, and its control by operant conditioning.
Often, obstetricians try to ensure that the knots are buried within the body of the external anal sphincter
muscle, rather than on the surface of the fascial sheath of the sphincter.
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.
3] where the author measured the age related variations in thickness of external anal sphincter
and puborectalis muscles in normal children.
The technique for repairing obstetrical anal sphincter lacerations has traditionally been the end-to-end repair technique, but this is associated with up to a 50% rate of disrupted external anal sphincter
and/or fecal incontinence.
The lesion appeared to originate from between the internal and external anal sphincters
, with the superior part of the lesion therefore lying in the intersphincteric plane and the lower part bulging out into the perineum.
A transverse incision was made at 9 O' clock or 3 O' clock position and blunt dissection was carried in the plane between internal and external anal sphincters
At 6 weeks post partum, all women were examined at a dedicated perineal clinic, where they completed another questionnaire to assess new bowel symptoms and received a pelvic exam and an endoanal ultrasound exam to determine the state of both internal and external anal sphincters
This imaging technique is a good method to assess the anatomic integrity of internal and external anal sphincters