Document Detail


Anal resting pressures at manometry correlate with the Fecal Incontinence Severity Index and with presence of sphincter defects on ultrasound.
MedLine Citation:
PMID:  18437494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: We describe the relationship between anorectal manometry, fecal incontinence severity, and findings at endoanal ultrasound. METHODS: A total of 351 women completed the Fecal Incontinence Severity Index, underwent anorectal manometry, and endoanal ultrasound. Severity index and manometry pressures in 203 women with intact sphincters on ultrasound were compared with pressures in 148 women with sphincter defects. Relationships between resting and squeeze pressures, severity index, and size of sphincter defects were evaluated. RESULTS: Mean severity index in patients with and without sphincter defect was 35.7 vs. 36.7 (not significant). Worsening index correlated with worsening mean and maximum resting pressure (P < 0.0001). Differences were observed in mean and maximum resting pressure between the patients with and without sphincter defects (26.6 vs. 37.2, P < 0.0001; 39.4 vs. 51.7, P < 0.001). Resting pressures correlated with the sizes of defect (P < 0.0001). CONCLUSIONS: Patients with and without sphincter defects had similar severity scores, but patients with defects had a significant decrease in resting pressures. Patients with larger sphincter defects had lower severity scores and resting pressures. Until a manometry cutoff can be set to discriminate between absence and presence of defects, both manometry and ultrasound should be offered to patients with history of anal trauma.
Authors:
Liliana Bordeianou; Kil Yeon Lee; Todd Rockwood; Nancy N Baxter; Ann Lowry; Anders Mellgren; Susan Parker
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-25
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-03     Completed Date:  2008-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1010-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. lbordeianou@partners.org
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MeSH Terms
Descriptor/Qualifier:
Anal Canal / injuries,  physiopathology*,  ultrasonography*
Endosonography
Fecal Incontinence / diagnosis,  etiology,  physiopathology*
Female
Follow-Up Studies
Humans
Manometry
Middle Aged
Pressure
Prospective Studies
Rest / physiology*
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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