The Levator Ani Syndrome is a form of functional anorectal pain that can be disabling. Criteria for its diagnosis were provided by the Rome II conference.


Synonyms: puborectalis syndrome, chronic proctalgia, pyriformis syndrome, pelvic tension myalgia, levator spasm


Criteria for the diagnosis of functional levator ani syndrome - all of the following:

(1) A duration of symptoms >= 12 cumulative weeks over the past 12 months (may or may not be consecutive).

(2) Chronic or recurrent rectal pain, feeling of pressure or aching that may be worse with sitting or lying down.

(3) Episodes last 20 minutes or longer (may last several days)

(4) The symptoms can be elicited by digital massage of the levator ani muscle.

(5) Exclusion of other causes following a complete examination.



• In proctalgia fugax the pain is much shorter in duration.



(1) ischemia

(2) inflammatory bowel disease

(3) cryptitis

(4) intramuscular abscess

(5) fissure

(6) hemorrhoids

(7) prostatitis (in males)

(8) solitary rectal ulcer


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