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Information on spastic pelvic floor - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1716 Questions
User :   Hi
User :   Hi
User :   Iam.Dr.
User :   Hi Dr. xxx
User :   Please post your query
User :   I have some questions about spastic pelvic floor (also Dx as levitor ani spasm)
User :   I had been suffering from abdominal pain, rectal bleeding and pressure for the last 3 years
User :   and outlet type constipation
User :   since when you have this?
User :   It started in the summer of 2007 I think
User :   May i know your age ?
User :   26 yo male
User :   sorry 27 now
User :   I've had numerous complications like a thrombosis of a pile
User :   and fissures
User :   which were treated with surgery and botox injections
User :   nitro glycerin ointment
User :   valium suppositories
User :   I have also had increased urinary ugency as a result of nerve irritation
Doctor :   Ok
User :   but after an MRI, they said my pelvic floor muscles weren't relaxing and that I needed special physical therapy
User :   So I have been doing physical therapy with external and internal trigger point releases, to get the pelvic floor to relax
User :   and have been taking valium suppositories
Doctor :   ok
User :   I have found this helpful but the levator muscles were still too tight, so I had another 100U of botox injected in the levator muscle about a week ago
User :   I am also eating a very careful diet and drinking lots of water and excercize
Doctor :   ok
User :   But my bowels got stuck again for over 2 days and today when I finally passed stool, I had pain and bleeding again
User :   So obviously more needs to be done, and I need some suggestions.
Doctor :   As this is a chronic problem and you have been on the physical therapy
Doctor :   valium suppositories
User :   And botox injections
Doctor :   These kind of episodes tend to happen less frequently
User :   yes
Doctor :   Botox is a temporary solution
Doctor :   and it is not the cure
User :   these episodes have reduced in frequency with the therapy but they keep coming back and I am investing a lot of money and time each day just for the therapy and meds
Doctor :   Yes
User :   I need a cure so I can return to work and regular activities
User :   things got better but not 100% and these episodes are not okay to have, because I plan to travel a lot when I get better
Doctor :   Ok this is a problem which has no complete cure
User :   Also, the valium requires refrigeration and is difficult to transport
Doctor :   and the symptomatic treatment is the only way out
Doctor :   Electrotherapy with galavanic stimulation is the best way proved
User :   I have done biofeedback
Doctor :   Yes
User :   but no stimulation with it
User :   they said muscle coordination is good and the tone is more healthy now
User :   but things are tigh
User :   t
Doctor :   Ok
Doctor :   anal sphincter massage under local or regional anesthesia can be tried, but the benefit is unclear.
User :   Can the muscle be dialated?
User :   I have the massage done
User :   2 times per week
User :   no anesthesia is needed because it is no longer painful for the massage
Doctor :   Ok
User :   this is done as myofascial release
Doctor :   As far as I know these are the treatments available
Doctor :   A proctologist or a Gastrosurgeon should be able to help you
Doctor :   I am a General practitioner and I have treated with only these
User :   I have seen 2 Gastroenterologists and 4 colo rectal surgeons
Doctor :   ok
User :   Do you know if dialation is ever used for this?
Doctor :   NOt that I know of
User :   ok, so no other treatments that you are aware of? I had to quit my job and leave school and can't travel either because of this...
Doctor :   I understand that
Doctor :   The recent treatment is the EMG biofeedback
Doctor :   but that did not work for you
User :   it helped but the problem keeps coming back
Doctor :   So I am sorry that I am not able to help you at this time
Doctor :   Ok
Doctor :   yeah as said by me no treatment is cure
User :   ok, thank you
Doctor :   I shall get back to you if I find any thing useful
Doctor :   after a good research on it
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