Correlation between anal manometry and endosonography in females with faecal incontinence
Authors: Titi, M. A.; Jenkins, J. T.; Urie, A.; Molloy, R. G.
Source: Colorectal Disease, Volume 10, Number 2, February 2008 , pp. 131-137(7)
Publisher: Blackwell Publishing
Key:
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
Abstract:
Objective Female faecal incontinence (FI) is largely because of sphincter injury at childbirth. Sphincter assessment aims to identify surgically correctable defects. We aimed to identify endoanal ultrasonography (EAUS) parameters that correlate with sphincter function. Method One hundred females with FI and 28 healthy asymptomatic females were prospectively assessed. Wexner FI score was recorded and all subjects underwent anorectal manometry and EAUS. Multiple EAUS parameters were assessed and correlated with external (EAS) and internal (IAS) anal sphincter function, determined by maximum squeeze pressure (MSP) and maximum resting pressure (MRP) respectively. Parameters included sphincter quality (echogenicity), thickness, perineal body thickness (PBT) and defect characteristics (angle, length). Results are expressed as medians and interquartile range (IQR). Results Median Wexner score was 14 (12-17). Maximum EAS thickness significantly correlated with MSP (P = 0.019). EAS defects were detected in 84 patients and seven controls (P < 0.0001). Full-length EAS defects were only detected in FI group and had significantly lower MSP [MSP mmHg: full length 85 (65-103) vs partial length 119 (75-155), P = 0.006]. FI patients were more likely to have a mixed echogenicity of EAS compared with controls. EAS ring quality, PBT and defect angle were not significant. IAS quality was significantly associated with MRP [MRP mmHg: uniform 62 (43-82) vs mixed 47 (30.5-57.5), P = 0.002]. Conclusion Certain EAUS parameters can be predictive of anal sphincter function. These include the presence of an EAS defect and its length, EAS maximum thickness, IAS ring quality. Integration of these parameters can give better EAUS correlation with manometry for FI evaluation.Keywords: Faecal incontinence; anal manometry; anal endosonography; sphincter defect; perineal body thickness
Document Type: Research article
DOI: 10.1111/j.1463-1318.2007.01312.x
Key:
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
- Free Content
- New Content
- Subscribed Content
- Free Trial Content
Click here for Page Help