The urorectal syndrome caused by abdomen-levator incoordination in children

We have studied thirty four children (mean age 6.6 years) with severe functional constipation, associated or not with encopresis. In twenty three cases the defecography showed a persistent anorectal angle due to failure of puborectalis sling relaxation during defecation straining. Voiding disorders, unknown to parents, but demonstrated by obstructive uroflowmetry, are also seen in nineteen of these children. Therefore is definite a true urorectal outlet obstruction syndrome by spastic pelvic floor mechanism. The exact etiologic factor of these functional abnormalities remains undefined. All children were managed by biofeedback training. A satisfactory result (with six months follow up), has obtained in fourteen cases.