Document Detail


Unsuspected sphincter defects shown by anal endosonography after anorectal surgery. A prospective study.
MedLine Citation:
PMID:  7882786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Anorectal surgery can lead to fecal soiling and incontinence. Whether surgery changes the anatomy and causes symptoms is unknown. Anatomic changes can be visualized by anal endosonography. METHODS: We studied 50 patients after hemorrhoidectomy (24), fistulectomy (18), and internal sphincterotomy (8). Symptoms were assessed, and anal endosonography, anal manometry, mucosal electrosensitivity, and neurophysiologic tests were performed. RESULTS: In 23 (46 percent) patients, a defect of the anal sphincter was found (13 patients had an internal sphincter defect, 1 had an external sphincter defect, and 9 had a combined sphincter defect), 3 after hemorrhoidectomy, 13 after fistulectomy, and 7 after internal sphincterotomy. Seven patients had symptoms, and they all had a sphincter defect. In the other 16 of 23 patients (70 percent), the sphincter defect did not produce symptoms. An internal sphincter defect lowered maximum basal pressure and shortened sphincter length. CONCLUSION: Anal endosonography can reveal sphincter defects after anorectal surgery. Seventy percent of the patients in this group had no complaints; therefore, defects were unsuspected. This has clinical implications in the evaluation of patients with fecal incontinence.
Authors:
R J Felt-Bersma; R van Baren; M Koorevaar; R L Strijers; M A Cuesta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  38     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-10     Completed Date:  1995-04-10     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  249-53     Citation Subset:  IM    
Affiliation:
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anal Canal / physiopathology*,  surgery,  ultrasonography
Electric Stimulation
Fecal Incontinence / diagnosis,  etiology,  ultrasonography
Female
Fissure in Ano / surgery
Hemorrhoids / surgery
Humans
Male
Manometry
Middle Aged
Mucous Membrane / physiopathology
Postoperative Complications*
Prospective Studies
Rectal Fistula / surgery
Rectum / surgery*
Sensation

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


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