Balloon expulsion test facilitates diagnosis of pelvic floor outlet obstruction due to nonrelaxing puborectalis muscle

James W. Fleshman*, Zeev Dreznik, Edward Cohen, Robert D. Fry, Ira J. Kodner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We compared balloon expulsion, defecography, colonic transit times, anal manometry, and electromyography in 21 patients with severe constipation. Defecography demonstrated nonrelaxation of the sphincter during straining in all patients. Only 12 patients were unable to expel a balloon. Colonic transit was normal (five) or showed rectosigmoid delay (seven). All 12 patients were offered biofeedback. The nine patients able to expel a balloon had normal colonic transit (six) or colonic inertia (two). Rectosigmoid delay was due to severe intussusception in one patient. Anal manometry and pudendal nerve latencies revealed no difference between those who could and those who could not expel a balloon. Balloon expulsion seems to be a more reliable way to diagnose pelvic floor outlet obstruction due to nonrelaxation of the puborectalis muscle. Nonrelaxation of the sphincter on defecography should be correlated with balloon expulsion and colonic transit studies.

Original languageEnglish
Pages (from-to)1019-1025
Number of pages7
JournalDiseases of the Colon and Rectum
Volume35
Issue number11
DOIs
StatePublished - Nov 1992
Externally publishedYes

Keywords

  • Anal manometry constipation
  • Balloon expulsion
  • Defecography
  • Nonrelaxing puborectalis muscle

Fingerprint

Dive into the research topics of 'Balloon expulsion test facilitates diagnosis of pelvic floor outlet obstruction due to nonrelaxing puborectalis muscle'. Together they form a unique fingerprint.

Cite this