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Abstract：
BACKGROUND: Anorectal pain is a symptom which may have both structural and functional causes, and can, sometimes, develop into a chronic pain syndrome. Functional causes in particular are challenging to treat when conservative treatment measures fail. Botulinum toxin A (BTX-A) can be applied to relax the anal sphincter and/or levator ani muscle to break the vicious circle of pain and contraction. In our tertiary referral proctology clinic, we evaluated the outcome of patients treated with BTX-A for chronic functional anorectal pain.
METHODS: Our electronic database was searched for patients who had BTX-A treatment for chronic functional anorectal pain from 2011 to 2016. All medical data concerning history, treatments, and clinical outcome were retrieved. The clinical outcome (resolution of pain) was scored as good, temporary, or poor.
RESULTS: A total of 113 patients [47 (42%) males; age 51years, SD 13 years, range 18-88 years] with chronic functional anorectal pain were included. The outcome of BTX-A treatment was good in 53 (47%), temporary in 23 (20%), and poor in 37 (33%). To achieve this outcome, 29 (45%) patients needed a single treatment, 11 (44%) a second treatment, and 13 (54%) ≥ 3 treatments.
CONCLUSIONS: Chronic functional anorectal pain can be treated successfully with BTX-A in 47% of patients who fail conservative management. Repeated injections may be needed to ensure complete cure in a subgroup of patients.
METHODS: Our electronic database was searched for patients who had BTX-A treatment for chronic functional anorectal pain from 2011 to 2016. All medical data concerning history, treatments, and clinical outcome were retrieved. The clinical outcome (resolution of pain) was scored as good, temporary, or poor.
RESULTS: A total of 113 patients [47 (42%) males; age 51years, SD 13 years, range 18-88 years] with chronic functional anorectal pain were included. The outcome of BTX-A treatment was good in 53 (47%), temporary in 23 (20%), and poor in 37 (33%). To achieve this outcome, 29 (45%) patients needed a single treatment, 11 (44%) a second treatment, and 13 (54%) ≥ 3 treatments.
CONCLUSIONS: Chronic functional anorectal pain can be treated successfully with BTX-A in 47% of patients who fail conservative management. Repeated injections may be needed to ensure complete cure in a subgroup of patients.
摘要：
背景：肛肠疼痛是一种可能具有结构和功能原因的症状，并且可以，有时,发展成慢性疼痛综合征.当保守治疗措施失败时，功能性原因尤其具有挑战性。肉毒杆菌毒素A（BTX-A）可用于放松肛门括约肌和/或肛提肌，以打破疼痛和收缩的恶性循环。在我们的三级转诊直肠科诊所，我们评估了BTX-A治疗慢性功能性肛门直肠疼痛患者的结局.
方法：我们的电子数据库搜索了2011年至2016年BTX-A治疗慢性功能性肛门直肠疼痛的患者。所有关于病史的医疗数据,治疗,并检索临床结果。临床结果（疼痛缓解）评分良好，temporary,或者穷。
结果：共有113例患者[男性47例（42%）；年龄51岁，SD13年，包括18-88岁]慢性功能性肛门直肠疼痛。BTX-A治疗的结果是良好的53（47％），暂时在23(20%)，和差在37（33％）。为了实现这一结果,29例（45%）患者需要单一治疗，11（44%）第二次治疗，13例（54%）≥3例治疗。
结论：在47%的保守治疗失败的患者中，BTX-A可以成功治疗慢性功能性肛门直肠疼痛。可能需要重复注射以确保患者亚组的完全治愈。
方法：我们的电子数据库搜索了2011年至2016年BTX-A治疗慢性功能性肛门直肠疼痛的患者。所有关于病史的医疗数据,治疗,并检索临床结果。临床结果（疼痛缓解）评分良好，temporary,或者穷。
结果：共有113例患者[男性47例（42%）；年龄51岁，SD13年，包括18-88岁]慢性功能性肛门直肠疼痛。BTX-A治疗的结果是良好的53（47％），暂时在23(20%)，和差在37（33％）。为了实现这一结果,29例（45%）患者需要单一治疗，11（44%）第二次治疗，13例（54%）≥3例治疗。
结论：在47%的保守治疗失败的患者中，BTX-A可以成功治疗慢性功能性肛门直肠疼痛。可能需要重复注射以确保患者亚组的完全治愈。
