Vectormanometry for differential diagnosis of fecal incontinence.
OBJECTIVE
This study was designed to investigate the reliability of three-dimensional vectormanometry for differential diagnosis of fecal incontinence.


METHODS
Eight-channel, continuous pull-out perfusion manometry was performed on 23 female patients with traumatic (n = 11) or idiopathic (n = 12) incontinence, respectively.


RESULTS
At rest, the minimum sector pressure of patients with traumatic incontinence (32 +/- 14 mmHg) was significantly lower than it was in the controls (76 +/- 16 mmHg) and in those with idiopathic incontinence (64 +/- 28 mmHg) (P < 0.001). At maximum squeezing, the minimum sector pressure was 57 +/- 22 mmHg in patients with traumatic incontinence and 79 +/- 33 mmHg in those with idiopathic incontinence, both being significantly lower than in the control group with 152 +/- 27 mmHg (P < 0.001). The asymmetry index of the patients with a sphincter defect was significantly higher, both at rest (23 +/- 13 percent) and squeeze (26 +/- 12 percent), in comparison with the control group (7 +/- 2 percent at rest and 6.2 +/- 1.6 percent at squeeze) and the patients with idiopathic incontinence (10 +/- 5 percent at rest and 8.4 +/- 4 percent at squeeze).


CONCLUSIONS
Three-dimensional vectormanometry identifies localized pressure deficits in the anal canal, thereby differentiating between sectorial and global sphincter insufficiency.
Braun
J C
JC
Department of Surgery, Medical Faculty, Rhenish-Westphalian Technical University, Aachen, Germany.
Treutner
K H
KH
Dreuw
B
B
Klimaszewski
M
M
Schumpelick
V
V
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D005082:Physical Exertion; D011312:Pressure; D015203:Reproducibility of Results; D012146:Rest; D012737:Sex Factors