ABSTRACT
OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1
x 51.2 years-old, SE 4.1) and 58 females (69.9
, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: Colonic Double-contrasted Rx, rectum-sigma endoscopy, and eventually a Colonofibroscopy Historic facts and syndromic protocol. Diagnosis criteria: 1) Perineal inspection: perineal contraction with pujo; 2) Rectal tact; 3) Ano-Rectum manometry with perfused system; 4) 150 ml Rectal balloon expulsion dynamic; 5) Utoreported signs and symptoms from a cuestionnaire ad hoc. Division into evolutive groups (continuous and intermittent). Division by age (< = 5, 5.1-25, > 25 years old). Experiment design: descriptive, comparative, correlation, prospective, simple blind. STATISTICS: Levene, descriptive, chi square, ANOVA, Kruskall-Wallis, Kendal tau b. RESULTS: 1) Difference in sex proportion was significative (p = 0.0001); 2) There were not differences between sexes in age media at the moment of the study (p = 0.92; 3) The continue evolutive form represented 77.1
, (p = 0.0001) but there werent differences between sexes (p = 0.19) There werent evolutive differences between age groups. (p = 0-78) 4) Age of onsec: x = 24.04 years-old, SE 2.02 (4-80 years-old), without differences between sexes (p = 0.16). 14.5
started before age of 5, 85
after that age, without differences between sexes (p = 0.07); 5) The time of evolution x = 26.7 years, SE 2.21, without differences between sexes (p = 0.25); 6) Potential causes were divides into tree categories: I [quot ]the patient doesnt remember associated facts[quot ] (30.1
, II: psychological or physical stress (39.8
), III: facts related to sexual trauma (30.1
). The differences (p = 0.0001); 7) Analyzed in general by sec, the most common cause was psychological-physical stress rather than sexual trauma in men, while among women sexual trauma was most common than psychological-physical stress (p = 0.03); 8) Analyzed by age groups: in the under 5 years-old group: main cause was [quot ]I dont remember[quot ]. In 5.1-25-years-old group: sexual trauma; and psychological-physical stress was the main cause in > 25 years-old group (p 0.0001). CONCLUSIONS: 1) Women suffer from or consult much more frequently than man; 2) Once the disease is present, there would not be differences in age, age of onset, or time or evolution into proportions by sex; 3) The continue forms were the predominant ones; 4) The probable associated causes vary for each age group; 5) The sub-group [quot ]I dont remember[quot ] could represent in many cases a mismatch learning, but not constantly (there are cases of stress in familiar context); 6) In the subgroup [quot ]late childhood-adolescence[quot ] the predominant causes were traumatic experiences in erotic zones (rapping intent, sexual abuse, fantasies, elimination of parasites by the anus); 7) in the subgroup [quot ]older than 25 years-old[quot ] the predominant causes were physical stress, (violence, accidents, surgery) or emotional stress (familiar environment, social environment, affective losses). Some paradigmatic cases are presented. Anismus would be a complex situation involving an striated, voluntary, automatizated muscle (puborectalis) controlling independently genital-sexual, urinary and ano-rectal functions.
