Abstract：
INTRODUCTION:Chronic idiopathic anal pain (CIAP) remains a diagnosis of exclusion. Its study and management still lack a standardized protocol. The aim of this study is to evaluate the results obtained with the diagnostic-therapeutic protocol established in our service. MATERIAL AND METHODS:We performed a retrospective study of patients diagnosed with CIAP at the Colorectal Unit of the General University Hospital of Elche, between 2005 and 2011. RESULTS:We evaluated 57 patients with a diagnosis of chronic anal pain for functional anorectal disease (FAD). After the application of our diagnostic protocol, final diagnosis of chronic anal pain (CAP) was achieved in 43 cases (75%), including 22 cases of descending perineum syndrome, 12 of proctalgia fugax, 2 of pudendal neuritis and 7 of coccydynia. In 14 patients exclusion diagnosis of CIAP was established. Among the therapies used on patients with CIAP, biofeedback combined with conservative measures improved symptoms in 43% of the cases. Sacral nerve stimulation was assessed in patients who did not respond to other treatments. CONCLUSION:Through proper anamnesis, physical examination and complementary tests, a specific diagnosis of the cause of CAP by FAD can be achieved, reducing exclusion diagnosis of CIAP to 25% of cases. Conservative measures combined with biofeedback achieved an improvement in pain in more than 40% of the cases of CIAP in our study. Sacral nerve stimulation can be considered as a treatment option in refractory cases.
journal_name
Cir Espjournal_title
Cirugia espanolaauthors
Armañanzas L,Arroyo A,Ruiz-Tovar J,López A,Santos J,Moya P,Gómez MA,Candela F,Calpena Rdoi
10.1016/j.ciresp.2013.09.012subject
Has Abstractpub_date
2015-01-01 00:00:00pages
34-8issue
1eissn
0009-739Xissn
1578-147Xpii
S0009-739X(13)00369-2journal_volume
93pub_type
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