ABSTRACT
Tenesmus is an unpleasant sensation of rectal fullness and needing to open the bowels. It can occur after an abdomino-perineal resection of the rectum, in which case it is known as 'phantom rectum.' Tenesmus is usually caused by either a rectal tumour or pelvic recurrence. Impacted faeces can also cause the problem or make it worse. Tenesmus is due to pressure on the stretch receptors in the levator ani muscles. Bladder tenesmus causes the feeling of a full bladder and may be caused by a tumour enlarging either within the bladder or in the pelvis. Bladder spasm and discomfort may also be associated with other bladder problems, including retention, infection, calculi, clots or even a catheter. Defaecation, even when 'successful', can cause worsening of the tenesmoid pain and is therefore associated with anxiety and fear.
