Anal endosonography and manometry: comparison in patients with defecation problems.
OBJECTIVE
Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors.


METHODS
For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles.


RESULTS
Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance.


CONCLUSIONS
Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.
Schäfer
R
R
Department of Gastroenterology and Infectiology, Heinrich Heine University, Düsseldorf, Germany.
Heyer
T
T
Gantke
B
B
Schäfer
A
A
Frieling
T
T
Häussinger
D
D
Enck
P
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology; D003672:Defecation; D019160:Endosonography / Q000592:standards*; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000592:standards*; D008875:Middle Aged; D011312:Pressure; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012727:Sex Characteristics; D016037:Single-Blind Method