Correlation of anorectal electromanometry and anorectal three-dimensional ultrasound findings in patients with fecal incontinence

Author:

Betinardi Tracy Mary1,Lima Doryane Maria dos Reis12,Kurachi Gustavo3,Bonatto Mauro Willemann14,Tanaka Tomaz Massayuki15,Sagae Univaldo Etsuo16

Affiliation:

1. Faculdade Assis Gurgacz, Cascavel, PR, Brazil

2. Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil

3. Coloproctologist, Brazil

4. Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil

5. Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil

6. Universidade de São Paulo (USP), São Paulo, SP, Brazil

Abstract

Abstract Objective To show the correlation of anorectal electromanometry and three-dimensional anorectal ultrasonography in patients with fecal incontinence. Method Prospective study involving 34 women (mean age: 55 years) with a diagnosis of fecal incontinence. The samples were submitted to three-dimensional anorectal ultrasonography/Echodefecography and anorectal electromanometry. Results Based on anorectal electromanometry data, 70.5% of 34 patients had hypotonia at rest, 64.7% had hypotonic contraction, 52.9% had both hypotonia at rest and hypotonic contraction, and 44.1% had anismus. By three-dimensional anorectal ultrasonography, 32.3% had internal anal sphincter injury, 79.4% had external anal sphincter injures, and 26.4% had both internal and external anal sphincter injuries. In 38.2%, anismus was suggested and 50% showed rectocele. Overall, only 5.8% had normal results for anorectal electromanometry combined with three-dimensional anorectal ultrasonography. Kappa index was 0.297 and the presence of anismus through anorectal electromanometry and three-dimensional anorectal ultrasonography was compared by Student's t test application, with p < 0.0001. Conclusion We conclude that there was a reasonable agreement in the comparison of sphincter hypotonia by anorectal manometry and sphincter injury by anorectal three-dimensional ultrasonography in a group of patients with fecal incontinence. The incidence of anismus in patients with fecal incontinence is considerable, and the therapeutic approach in these patients should be modified.

Publisher

Georg Thieme Verlag KG

Subject

Gastroenterology

Reference27 articles.

1. Investigating and treating fecal incontinence: When and How;Lazarescu;Can J Gastroenterol,2008

2. Combined anal sphincteroplasty and perineal reconstruction for fecal incontinence in women;Novi;JAOA,2009

3. Functional anorectal disorders;Bharucha;Gastroenterology,2006

4. Defecography: depiction of anorectal anatomy and pathology;Hilfiker;J Comput Assist Tomogr,1998

5. Experience of 4 years with open MR defecography: pictorial review of anorectal anatomy and disease;Roos;Radiographics,2002

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