For patients with refractory anismus, standard treatments often fall short. Pelvic Botox injection into the puborectalis muscle is a breakthrough therapy. In this article, I discuss how Botox treats anismus.
Mechanism of Action
Botox temporarily relaxes the puborectalis muscle for 4 to 6 months. This prevents paradoxical contractions during defecation, restoring the correct anorectal angle and allowing stool to pass without straining.
Re-educating the Muscle
The temporary relaxation window provides an ideal opportunity for patients to practice proper defecation coordination. Combined with pelvic physical therapy, it leads to long-term permanent relief.