Spastic Pelvic Floor Syndrome refers to a functional disorder where the pelvic floor muscles contract instead of relaxing during defecation.

bubble_chart Clinical Manifestations

It is more common in women, with a male-to-female ratio of approximately 1:2. Symptoms include difficulty in defecation, discomfort, and pain, with bowel movements occurring once every 2 to 3 days. There may be abdominal distension and fullness, hematochezia, and chronic constipation. Straining during defecation increases intra-abdominal pressure, causing perineal descent and leading to gradual weakening of pelvic floor muscle tone. The perineal nerves may also be damaged. Other secondary changes may occur (such as enterocele, visceral prolapse, etc.). Digital rectal examination may reveal rectocele, loose mucous membrane, or internal and external hemorrhoids.

bubble_chart Auxiliary Examination

X-ray contrast examination: Characterized by the "goose sign," where the lateral sitting film is placed vertically (with the pubic symphysis facing upward), the entire image resembles a goose swimming in water; the anterior rectum is likened to the goose's head, the anal canal to the beak, the spastically narrowed distal rectum to the neck, and the proximal rectum and distal sigmoid colon to the body and tail. The occurrence rate of the "goose sign" is 100%.

bubble_chart Diagnosis

The diagnosis is primarily based on clinical symptoms and X-ray contrast examination showing the "goose sign." Other auxiliary examinations include anal manometry, pelvic floor electromyography, and colonic transit time. The diagnosis can be established after excluding organic causes of defecation difficulty.

Physical therapy and biofeedback therapy may provide short-term benefits. If other complications are present, surgical treatment should be considered.

bubble_chart Complications

Concurrent intestinal hernia, visceral prolapse, etc.