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The abdominal approach carries a small risk of impotence in males e. This operation aims to "remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall with the use of a circular stapler". It is difficult to treat, and treatment is aimed at minimizing symptoms. This pressure is produced by the modified valsalva manovoure attempted forced exhalation against a closed glottis, resulting in increased abdominal and intra-rectal pressure. When it occurs in the rectum, some believe to be an interchangeable diagnosis with SRUS since the histologic features of the conditions overlap. This is most likely a denervation injury to the external anal sphincter.
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