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Constipation due to pelvic floor disorders remain a therapeutic challenge. Biofeedback therapy is considered as the first-choice treatment for pelvic floor disorders, whenever dedicated expertise is available. Type A botulinum toxin has been used to selectively weaken the external anal sphincter and puborectalis muscle in constipated patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>Eighty-two patients with chronic outlet obstruction constipation were treated with 100 units type A botulinum toxin, injected into the puborectalis muscle and the external anal sphincter.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At the 2-month evaluation, a symptomatic improvement was noted in 69 patients. Seven (8.5%) patients had mild flatus incontinence. Stool frequency per week increased from 2.4\u2009\u00b1\u20090.9 to 5.1\u2009\u00b1\u20091.0 (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001). Anorectal manometry demonstrated decreased tone during straining from 91\u2009\u00b1\u200928\u00a0mmHg to 61\u2009\u00b1\u200927\u00a0mmHg (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001). Defecography after the treatment showed improvement in anorectal angle during straining, which increased from 96\u2009\u00b1\u200912\u00b0 to 124\u2009\u00b1\u200914\u00b0 (<jats:italic>P<\/jats:italic>\u2009=\u20090.0001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Type A botulinum toxin relaxes the puborectalis muscle. Pressure values decline after the treatment. Transrectal ultrasonography to guide injections is a safe procedure. Repeated injections were needed to maintain the clinical improvement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00384-024-04795-5","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T22:33:30Z","timestamp":1737498810000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outlet type constipation in adult patients treated with type A botulinum toxin: a cohort study"],"prefix":"10.1007","volume":"40","author":[{"given":"Giuseppe","family":"Brisinda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Fico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Tropeano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Cariati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Altieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Misuriello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Pepe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Fransvea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Michela","family":"Chiarello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"4795_CR1","doi-asserted-by":"publisher","first-page":"e14885","DOI":"10.1111\/nmo.14885","volume":"36","author":"BE Lacy","year":"2024","unstructured":"Lacy BE, Xu Y, Taylor DCA, Kosch KJ, Dobrescu R, Morlock A et al (2024) Treatment for chronic idiopathic constipation: use and satisfaction from a nationwide survey of US participants. 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