Document Detail


Functional correlates of anal canal anatomy: puborectalis muscle and anal canal pressure.
MedLine Citation:
PMID:  16606349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Resting and squeeze pressures in the anal canal are thought to reflect the contributions of the internal anal sphincter (IAS) and the external anal sphincter (EAS) respectively. Role of the puborectalis muscle (PRM) in the genesis of anal canal pressure is not known. OBJECTIVES: To determine the functional correlates of anal canal anatomy. METHODS: Seventeen asymptomatic nulliparous women were studied using simultaneous 3D ultrasound images and manometry of the anal canal. Ultrasound images were recorded using a transducer placed at the vaginal introitus and pressures were recorded with a side-hole manometry catheter using a station (every 5 mm) pull-through technique. Pressures were recorded at rest and during voluntary squeeze. RESULTS: Anal canal high pressure zone was 39 +/- 1 mm in length. The IAS, EAS, and PRM were clearly visualized in the ultrasound images. EAS was located in the distal (length 19 +/- 1 mm) and PRM in the proximal part (length 18 +/- 1 mm) of the anal canal. The station pull-through technique revealed increases in pressure with voluntary squeeze in the proximal as well as distal parts of the anal canal. Proximal anal canal pressure, located in the PRM zone, showed greater circumferential asymmetry than the distal anal canal pressure, located in the EAS zone. CONCLUSIONS: (1) PRM contributes to the squeeze pressure in the proximal part of the anal canal and EAS to the distal anal canal. (2) PRM squeeze-related increase in anal canal pressure might be important in the anal continence mechanism.
Authors:
Jianmin Liu; Noelani Guaderrama; Charles W Nager; Dolores H Pretorius; Sonali Master; Ravinder K Mittal
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  101     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-22     Completed Date:  2006-06-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1092-7     Citation Subset:  IM    
Affiliation:
The Pelvic Floor Function and Disease Group, University of California, San Diego, La Jolla 92161, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / anatomy & histology*,  physiology*,  ultrasonography
Female
Humans
Manometry
Middle Aged
Muscle Contraction / physiology
Muscle, Skeletal / physiology*
Grant Support
ID/Acronym/Agency:
R01 DK066846/DK/NIDDK NIH HHS

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


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