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Constipation pp 247–256Cite as

Surgical Treatment of Puborectalis Hypertrophy

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Conclusion

Constipation is a complex disorder, the understanding of which remains superficial. Partial resection of the puborectalis muscle only releases the abnormal mechanism of defecation. This procedure, therefore, should be restricted to those patients who have definite evidence of outlet obstruction caused by hypertrophy of the puborectalis muscle and who fail to respond to conservative therapy. It is also imperative to correct inappropriate bowel habits and diet prior to surgery.

Both PPC and PH are poorly understood conditions which require further investigation. Puborectalis hypertrophy is a condition that causes outlet obstruction constipation. Although it has some similarity with PPC, it is an organic disorder caused by hypertrophy of the puborectalis muscle due to inflammation, congenital structure, trauma, or other etiologies. While PPC is a functional disorder and the structure of the puborectalis is normal, it does respond to biofeedback and botulinum toxin type-A injection, unlike PH. Only those patients who have definite evidence of outlet obstruction caused by hypertrophy of the puborectalis muscle, and who fail to respond to conservative therapy, should undergo division of the puborectalis muscle.

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Author information

Authors and Affiliations

  1. Department of Colorectal Surgery Changhai Hospital First Affiliating Hospital, Second Military Medical University, Shanghai, China

    De-hong Yu MD

  2. Department of Colorectal Surgery Third Affiliated Hospital Nanjing University of TCM, Second Military Medical University, Nanjing, China

    Hei-ying Jin MD, PhD

Authors
  1. De-hong Yu MD
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  2. Hei-ying Jin MD, PhD
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Editor information

Editors and Affiliations

  1. Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  2. Ohio State University Health Sciences Center at the Cleveland Clinic Foundation, Columbus, OH, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  3. University of South Florida College of Medicine, Tampa, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  4. Charles E. Schmitt College of Science, Florida Atlantic University, Boca Raton, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  5. University of Hull, Cattingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

  6. Hull and East Yorkshire NHS Trust, Castle Hill Hospital, Cottingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

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© 2006 Springer-Verlag London Limited

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Yu, Dh., Jin, Hy. (2006). Surgical Treatment of Puborectalis Hypertrophy. In: Wexner, S.D., Duthie, G.S. (eds) Constipation. Springer, London. https://doi.org/10.1007/978-1-84628-275-1_26

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  • DOI: https://doi.org/10.1007/978-1-84628-275-1_26

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-724-7

  • Online ISBN: 978-1-84628-275-1

  • eBook Packages: MedicineMedicine (R0)

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