title: Fecal incontinence: transvaginal US evaluation of anatomic causes.
abstract: OBJECTIVE
  To evaluate transvaginal ultrasonography (US) as an alternative to transanal US for determining the anatomic cause of fetal incontinence in women.
  
  
  METHODS
  Transvaginal US of the anal canal was performed in 28 women (aged 27-74 years) with fecal incontinence. A side-fire endorectal probe was inserted into the vagina and directed toward the posterior vaginal wall.
  
  
  RESULTS
  The internal anal sphincter (IAS) and external anal sphincter muscles were imaged as independent bands in all 28 patients. The calculated mean thickness of the IAS in patients aged younger than 55 years was not significantly different from that in patients aged older than 55 years (P=.31). Posttraumatic anterior muscle disruptions were detected in 16 women; three also had rectovaginal fistulas. A rectal fistula with abscess was detected in one of 12 patients with intact muscles. All muscle disruptions, fistulas, and abscesses were surgically confirmed.
  
  
  CONCLUSIONS
  Transvaginal US enables determination of the anatomic cause of fecal incontinence, allowing the surgeon to select patients who would benefit form surgical repair.
authors.affiliation: Division of Diagnostic Ultrasound, Department of Radiology, Thomas Jefferson University Hospital, Jefferson Medical College, Philadelphia, PA 19107, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Alexander
authors.forename: J B
authors.initials: JB
authors.lastname: Liu
authors.forename: D A
authors.initials: DA
authors.lastname: Merton
authors.forename: D A
authors.initials: DA
authors.lastname: Nagle
mesh_terms: D000367:Age Factors; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000293:injuries; D036861:Delivery, Obstetric / Q000009:adverse effects; D005242:Fecal Incontinence / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012003:Rectal Fistula / Q000150:complications / Q000000981:diagnostic imaging*; D012006:Rectovaginal Fistula / Q000150:complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods