Comparison of Botox Injection and Myomectomy for the Treatment of Resistant Functional Constipation in Children

Abstract

Background: Botox injection and myomectomy are two treatment options offered for treatment-resistan functional constipation; however, their comparative effectiveness remains controversial. Therefore, this study aimed to compare the outcomes of botox* injection and myomectomy in children with functional constipation. Methods: In this clinical trial study, 64 pediatric patients with functional constipation were divided into two groups of 32. The first group underwent myomectomy and the second group received Botox injection. Treatment outcomes were assessed and compared between the two groups one year after intervention using a Rome III–based constipation scoring system. Findings: In the Botox group, the mean constipation score based on a Rome III–based scoring system increased from 13.67 ± 5.24 before treatment to 36.80 ± 7.31 after treatment, showing a significant difference (P < 0.001). In the myomectomy group, the mean constipation score increased from 12.43 ± 4.72 to 36.18 ± 6.48 after treatment (P < 0.001). There was no significant difference in the mean post-treatment constipation scores between the botox and myomectomy groups (P = 0.74). Conclusion: The results of this study suggest that both Botox injection and myomectomy are effective in the treatment of functional constipation. However, considering the less invasive nature and fewer post-treatment complications associated with Botox injection, this approach may be preferable in selected patients. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved.