[Puborectalis syndrome: a cause of obstinate constipation]

Two patients with severe chronic constipation caused by spasmodic hypertrophy of puborectalis underwent partial resection of the muscle. Pre-operative anorectal manometry showed increased length of the anal canal. Concentric electromyography showed that the puborectalis muscle failed to relax during attempted defecation and patients were unable to expel a water-filled balloon from the rectum. After surgery they have a regular defecation without difficulty. We consider that partial resection of the puborectalis muscle is a useful procedure for the puborectalis syndrome.