Le périnée miroir de l'âme ?

Functional disorders of the perineum, anus and rectum are a frequent clinical manifestation. They affect between 11 % and 30 % of the population. There is an organic reason for these disorders in 30 % of the patients examined. In the latest revision of the Rome IV Criteria, anorectal function disorders include fecal incontinence, defecation disorders and chronic pain, including proctalgia fugax, levator ani syndrome, and pain of non-specific origin. In most cases, the origin and relevance of the pathophysiological mechanisms of anorectal functional disorders are uncertain and unclear. The somatic and vegetative duality of perineal innervation plays a major role in the difficulty of diagnosis and in the limited effectiveness of specific treatments. Functional anorectal disorders are a challenge for the clinician, their complexity requires a multidisciplinary approach both for their diagnosis and treatment. A better knowledge of the functioning of the visceral innervation and a prospective randomized evaluation of the known treatments will be indispensable contributions to the progress of the management of anorectal functional disorders.