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Chronic Anorectal Pain: Pathophysiological Aspects, Diagnosis, and Treatment

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Pelvic Floor Disorders: Surgical Approach

Part of the book series: Updates in Surgery ((UPDATESSURG))

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Abstract

Chronic anorectal pain is a syndrome made up of a complex interaction between neurological, musculoskeletal, and endocrine systems that is further affected by behavioral and psychological factors [1]. The ambiguity of the pathophysiology related to this pain has created several synonyms, but chronic idiopathic perineal pain is an umbrella term used to describe the subgroups of patients who present with chronic anorectal pain [2, 3].

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References

  1. Ger GC, Wexner SD, Jorge JM et al (1993) Evaluation and treatment of chronic intractable rectal pain — a frustrating endeavour. Dis Colon Rectum 36:139–145

    Article  PubMed  CAS  Google Scholar 

  2. Gunter J (2003) Chronic pelvic pain: an integrated approach to diagnosis and treatment. Obstet Gynecol Surv 58:615–623

    Article  PubMed  Google Scholar 

  3. Andromanakas NP, Kouraklis G, Alkiviadis K (2011) Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment. Eur J Gastroenterol Hepatol 23:2–7

    Article  Google Scholar 

  4. Thaysen ThEH (1953) Proctalgia fugax: a little known form of pain in the rectum. Lancet ii:243–246

    Google Scholar 

  5. Theile GH (1963) Coccygodynia: cause and treatment. Dis Colon Rectum 6:422–436

    Article  Google Scholar 

  6. Grant SR, Salvati EP, Rubin RJ (1975) Levator syndrome: an analysis of 316 cases. Dis Colon Rectum 18:161–163

    Article  PubMed  CAS  Google Scholar 

  7. Finamore P, Goldstein H, Whitmore K (2008) Pelvic floor muscle dysfunction: a review. J Pelvic Med Surg 14:417–422

    Article  Google Scholar 

  8. Thompson WG (1981) Proctalgia fugax. Dig Dis Sci 26:1121–1124

    Article  PubMed  CAS  Google Scholar 

  9. Bharucha AE, Trabuco E (2008) Functional and chronic anorectal and pelvic pain disorders. Gastroenterol Clin North Am 37:685–696

    Article  PubMed  Google Scholar 

  10. Mazzo L, Formento E, Fronda G (2004) Anorectal and perineal pain: new pathophysiologi-cal hypothesis. Tech Coloproctol 8:77–83

    Google Scholar 

  11. Walker E, Katon W, Harrop-Griffiths J et al (1988) Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sex abuse. Am J Psychiatry 145: 75–80

    PubMed  CAS  Google Scholar 

  12. Todd IP (1985) Clinical Evaluation of the Pelvic Floor. In: Henry MM and Swish M (eds), pp 187–188, Butterworth, London

    Google Scholar 

  13. Patel R, Appannagari A, Whang PG (2011) Coccydynia. Curr Rev Musculoskelet Med 1:223–226

    Article  Google Scholar 

  14. Hompes R, Jones OM, Cunningham C, Lindsey I (2011) What causes chronic idiopathic perineal pain? Colorectal Dis 13:1035–1039

    Article  PubMed  CAS  Google Scholar 

  15. Thiele GM (1950) Coccygodynia: the mechanism of its production and its relationship to anorectal disease. Am J Surg 79:110–116

    Article  PubMed  CAS  Google Scholar 

  16. Everaert K, Devulder J, Muynck M et al (2001) The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes. Int Urogynaecol J Pelvic Floor Dysfunct 12:9–14

    Article  CAS  Google Scholar 

  17. Neill ME, Swash M (1982) Chronic Perineal Pain: an unsolved problem. J R Soc Med 75:98–101

    Google Scholar 

  18. Wijffels NA, Collinson R, Cunningham C, Lindsey I (2010) What is the natural history on internal rectal prolapse? Colorectal Disease 12:822–830

    Article  PubMed  CAS  Google Scholar 

  19. Collinson R, Wijffels N, Cunningham C, Lindsey I (2010) Laparoscopic ventral rectopexy for internal rectal prolapse: short term functional results. Colorectal Dis 12:97–104

    Article  PubMed  CAS  Google Scholar 

  20. Hompes R, Lindsey I (2011) Chronic anorectal pain: a pathophysiological approach. In: Lindsey I, Nugent K, Dixon A (eds) Pelvic floor disorders for the colorectal surgeon, 1st edn. Oxford University Press, Oxford, pp 69–74

    Google Scholar 

  21. Jarrett ME, Wijffels NA, Slater A et al (2010) Enterocele is a marker of severe pelvic floor weakness. Colorectal Dis 7:158–162

    Google Scholar 

  22. Robert R, Labat JJ, Bensignor M et al (2005) Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation. Eur Urol 47:403–408

    Article  PubMed  Google Scholar 

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Correspondence to Oliver M. Jones .

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© 2004 Springer-Verlag Italia

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Joshi, H.M., Jones, O.M. (2004). Chronic Anorectal Pain: Pathophysiological Aspects, Diagnosis, and Treatment. In: Gaspari, A.L., Sileri, P. (eds) Pelvic Floor Disorders: Surgical Approach. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5441-7_11

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  • DOI: https://doi.org/10.1007/978-88-470-5441-7_11

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5440-0

  • Online ISBN: 978-88-470-5441-7

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