Levator Ani Syndrome

Levator ani syndrome consists of a dull aching or pressure discomfort high in the rectum.6 Patients may have a sensation of sitting on a ball or other intrarectal object. The pain may be precipitated by prolonged sitting or defecation, and seems to occur more often on the left side. The diagnostic criteria stipulated by an international committee consist of chronic or recurrent anorectal pain for 3 months in the preceding year (they do not have to be consecutive weeks or months). The episodes must last 20 minutes or longer. This problem seems to primarily affect women under 45 years of age. It is postulated that spasm of the levator muscles leads to these symptoms. Physical examination may be normal or demonstrate a tight band like levator muscle. Palpation of the levator may precipitate the pain.

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