title: A novel procedure to assess anismus using three-dimensional dynamic anal ultrasonography.
abstract: OBJECTIVE
  This study aimed to determine the value of three-dimensional (3D) dynamic endosonography in the assessment of anismus.
  
  
  METHODS
  Sixty-one women submitted to anorectal manometry were enrolled including 40 healthy women and 21 patients with anismus diagnosed by manometry. Patients were submitted to 3D endosonography. Images were acquired at rest and during straining and analysed in axial and midline longitudinal planes. Sphincter integrity was quantified. The angle between the internal edge of the puborectalis with a vertical line according to the anal canal axis was calculated at rest and during straining.
  
  
  RESULTS
  The angle increased in 39 of the 40 normal individuals and decreased in all patients with anismus during straining compared with the angle at rest (88.36 degrees ) and straining (98.65 degrees ) in normal individuals. In the anismus group, the angle decreased at rest (90.91 degrees ) and straining (84.89 degrees ). The difference between angle sizes in normal and anismus patients during straining was statistically significant (P < 0.5).
  
  
  CONCLUSIONS
  Three-dimensional endosonography is a useful method to assess patients with anismus confirming the anorectal manometric results.
authors.affiliation: Anorectal Physiology Unit, Clinic Hospital, Federal University of Ceara, Fortaleza, Ceara, Brazil. smregadas@hospitalsaocarlos.com.br
authors.forename: S M
authors.initials: SM
authors.lastname: Murad-Regadas
authors.forename: F S P
authors.initials: FS
authors.lastname: Regadas
authors.forename: L V
authors.initials: LV
authors.lastname: Rodrigues
authors.forename: M H L P
authors.initials: MH
authors.lastname: Souza
authors.forename: D M R
authors.initials: DM
authors.lastname: Lima
authors.forename: F R S
authors.initials: FR
authors.lastname: Silva
authors.forename: F S P R
authors.initials: FS
authors.lastname: Filho
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003248:Constipation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019160:Endosonography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D011446:Prospective Studies