Pathoetiology of Levator Ani Syndrome and Its Treatment With Translumbosacral Neuromodulation Therapy

INTRODUCTION:The pathoetiology and treatment of levator ani syndrome (LAS) remain unclear.METHODS:We evaluated pathophysiology using translumbosacral motor-evoked potentials and anorectal manometry in patients with LAS and compared with healthy controls. A cohort underwent translumbosacral neuromodulation therapy (TNT).RESULTS:Lumbar and sacral motor-evoked potential latencies were prolonged in 32 patients with LAS compared with 31 controls (P < 0.013), with higher prevalence of anal neuropathy (P = 0.026). TNT improved anorectal pain (P = 0.003) and neuropathy (P < 0.02) in 13 patients with LAS.DISCUSSION:Patients with LAS demonstrate significant lumbosacral neuropathy that may cause anorectal pain. TNT improved anorectal pain and neuropathy, providing a novel therapeutic option.