| A new method of assessing anal sphincter integrity using inverted vectormanometry. | |
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MedLine Citation:
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PMID: 16708160 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Vectorgraphy as an integrated mapping of radial pressure profiles of the anal canal has been used to attempt identification of pressure-related defects with doubtful reliability since vectorgraphs bear no resemblance to endoanal ultrasound scans at similar levels in the anal canal. This study aimed to devise a technique to enable vectorgraphy to be more representative of sphincter function and integrity. METHODS: Vectormanometry was performed in 50 patients with anorectal disorders using an Arndorfer pneumohydraulic system. "Normal" three-dimensional manometric images of each 0.5 cm of the anal sphincter were computer-generated by plotting anal pressures at rest and during squeeze radially around a central zero axis. The graphs were replotted with zero at the periphery and maximal anal pressure at the center. Both this ("inverted") and "normal" vectorgraphs were compared with endoanal ultrasound images at similar levels, assessing both internal and external anal sphincters. RESULTS: Standard vectormanometry produced excellent pictures of pressures throughout the anal canal; the anatomy however bore no resemblance to the pictures produced by endoanal ultrasound. The inverted vectographs showed a much better correlation with endoanal ultrasound at each 0.5-mm level of the anal canal, for both squeeze pressure graphs and external sphincter correlations and for resting pressure graphs and internal sphincter correlations. CONCLUSIONS: Accurate assessment of sphincter integrity is not possible when interpreting the vectormanometry graphs in the current format; however, inverted vectorgraphy gives good correlations with endoanal ultrasound and provides combined functional (pressure measurement) and anatomic (three-dimensional profile) information regarding the anal canal. |
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Authors:
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Geetinder Kaur; Angela Gardiner; Graeme S Duthie |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 49 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-08-10 Completed Date: 2006-09-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 1160-6 Citation Subset: IM |
Affiliation:
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Academic Surgical Unit, University of Hull Postgraduate Medical School, Castle Hill Hospital, Cottingham, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Anal Canal / physiopathology*, ultrasonography Anus Diseases / physiopathology*, ultrasonography Constipation / physiopathology Fecal Incontinence / physiopathology Female Humans Male Manometry / methods* Middle Aged Muscle Contraction Pressure |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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