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A Journal on Surgery

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Chirurgia 2002 April;15(2):63-4

language: Italian

The descending perineum syndrome

Cortese M.


Except the sensation of incomplete rectal evacuation with a constant desire to bear down, the features of descending perineum syndrome (passage of mucus, bleeding, vague dull aching pain in the perineum, etc.), are common with minor anal pathologies. Therefore the necessity of recognising it before any operation is underlined. A survey of the international literature for a clinical and therapeutic update is made. Diagnosis is easy: when a straining effort is made, suddenly, the perineum descends approx. three or four cm. On digital examination there is, usually, a lack of muscle tone and the presence of a mucosal prolapse. The descending perineum syndrome and neuropathy may not be associated with incontinence as long as sphincter pressure remain normal. Should any surgical treatment on sphincter be performed, anus continence could be involved! Treatment is symptomatic and directed to get rid of the constant desire to bear down.

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