Conclusions
The levator syndrome consists of the symptoms of pain, pressure or discomfort in the region of the rectum, sacrum, and coccyx. The patients often have gluteal discomfort and high rectal distress. Sitting may aggravate the disorder. Tenderness upon motion of the coccyx is not an important part of this syndrome. Therefore, the term “coccygodynia” should not be used. The syndrome affects women more frequently than men, and occurs most often in the fourth, fifth and sixth decades of life. Although the symptoms are at times vague, the diagnosis is easily made by those who suspect its presence. Tenderness of the levators is always present and most often unilateral and on the left. Its etiology is unclear. In a significant proportion of patients concomitant anorectal disease such as fissure and hemorrhoids is present. Massage with or without diathermy, hot sitz baths, and muscle relaxants such as diazepam have proven to provide effective treatment, and the recurrence rate after therapy is low.
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References
Simpson JY: coccygodynia and diseases and deformities of the coccyx. Med Times Gaz 40: 1031, 1859.
Smith WT: Levator spasm syndrome. Minn Med 42: 1076, 1959
Thiele GH: Tonic spasm of the levator ani, coccygeus and piriformis muscles: Its relationship to coccygodynia and pain in the region of the hip and down the leg. Trans Am Proctol Soc 37: 145, 1936
Thiele GH: Coccygodynia and pain in the superior gluteal region and down the back of the thigh: Causation by tonic spasm of the levator ani, coccygeus and piriformis muscles and relief by massage of these muscles. JAMA 109: 1271, 1937
Thiele GH: Coccygodynia: The mechanism of its production and its relationship to anorectal disease. Am J Surg 79: 110, 1950
Thiele GH: Coccygodynia: Cause and treatment. Dis Colon Rectum 6: 422, 1963
Wallace WC, Madden WM: Experience with partial resection of the puborectalis muscle. Dis Colon Rectum 12: 196, 1969
Wasserman IF: Puborectalis syndrome (rectal stenosis due to anorectal spasm). Dis Colon Rectum 7: 87, 1964
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Read at the joint meeting of the Section of Proctology, Royal Society of Medicine, the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, and the American Society of Colon and Rectal Surgeons, Washington, D. C., May 22 to 25, 1974.
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Grant, S.R., Salvati, E.P. & Rubin, R.J. Levator syndrome: An analysis of 316 cases. Dis Colon Rectum 18, 161–163 (1975). https://doi.org/10.1007/BF02587168
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DOI: https://doi.org/10.1007/BF02587168