Anal endosonography for assessment of anal incontinence with a linear probe: relationships with clinical and manometric features.
OBJECTIVE
This study determined correlations of clinical and manometric features with those of anal endosonography (AES).


METHODS
Between 1996 and 1999 we examined 58 patients suffering from anal incontinence (AI) by AES using a linear probe and anorectal manometry following a standardized protocol.


RESULTS
Twelve of the 58 patients (21%) had a history of anal surgery. Of the 40 women who had under-gone at least one vaginal delivery 22 (55%) sustained an obstetric tear and 12 (30%) required forceps for delivery. A perineal descent was observed in 24 of 32 women with AI (75%) and urinary incontinence in 24 of 44 (54%). An anal sphincter defect was diagnosed in 45 of the 58 patients (77%). The internal anal sphincter defects occurring in 42 patients (72%) were significantly associated with a decrease in the resting anal pressure. The external anal sphincter defects occurring in 33 patients (57%) were significantly associated with a decrease in the voluntary anal contraction.


CONCLUSIONS
Considering AES and manometric findings, a good correlation was observed between internal sphincter defect and the resting anal pressure and between external sphincter defects and the voluntary anal contraction. AI is usually associated with a global perineal insufficiency requiring special attention in terms of both training and medical management.
Barthet
M
M
Department of Gastroenterology, Hĵpital Nord, Marseille, France. mbarthet@mail.ap-hm.fr
Bellon
P
P
Abou
E
E
Portier
F
F
Berdah
S
S
Lesavre
N
N
Orsoni
P
P
Bouvier
M
M
Grimaud
J C
JC
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019160:Endosonography; D005242:Fecal Incontinence / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged