Anal resting pressures at manometry correlate with the Fecal Incontinence Severity Index and with presence of sphincter defects on ultrasound

被引:45
作者
Bordeianou, Liliana [1 ,2 ,3 ]
Lee, Kil Yeon [3 ,4 ]
Rockwood, Todd [5 ]
Baxter, Nancy N. [6 ,7 ]
Lowry, Ann [3 ]
Mellgren, Anders [3 ]
Parker, Susan [3 ,8 ]
机构
[1] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
[3] Univ Minnesota, Div Colon & Rectal Surg, Minneapolis, MN USA
[4] Kyung Hee Univ, Div Gen Surg, Seoul, South Korea
[5] Univ Minnesota, Hlth Policy & Management Sch Publ Hlth, Minneapolis, MN USA
[6] Univ Toronto, Dept Surg, Toronto, ON, Canada
[7] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada
[8] Univ Arizona, Dept Surg, Tucson, AZ USA
关键词
fecal incontinence; manometry; endoanal ultrasound; sphincher defect; resting pressure; FISI;
D O I
10.1007/s10350-008-9230-7
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
引用
收藏
页码:1010 / 1014
页数:5
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