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Pelvic floor dyssynergia (spastic pelvic floor) is a functional disorder that causes difficulty in evacuation of the rectum [1]. This entity is an under diagnosed condition which requires dynamic pelvic MRI as the current investigation of choice. Treatment includes biofeedback therapy, injection of botulinum toxin in to puborectalis ring and surgical division of the puborectalis ring. Surgical division of puborectalis ring has irreversible effects and has a risk of causing incontinence [2]. Botulism toxin injection provides a reversible paralysis of the puborectalis allowing the chance of diagnosis and treatment in short term.

Botulinum toxin injection to the puborectalis in the management of pelvic floor dyssynergia