Anal incontinence improvement after silicone injection may be related to restoration of sphincter asymmetry.
BACKGROUND
This study aimed to evaluate manometric parameters that may explain improvement in anal incontinence using a silicone bulking agent.


METHODS
Incontinent patients having internal sphincter defects were prospectively selected and injected with a silicone bulking agent. Manometry and endoanal ultrasound were performed before and 3 months after injections. Twenty continent healthy volunteers were used only for manometric comparison.


RESULTS
Thirty-five patients (28 females; mean age 60.3 years) and 20 controls entered this study. Patients had lower resting and squeeze pressures compared with controls (P < .05). Length of the high-pressure zone increased from 1 to 1.7 cm postinjection (P = .002). Asymmetry index showed a significant change postinjection (P < .001).


CONCLUSIONS
Despite considerable clinical improvement, no significant increase in manometric pressures was noted posttreatment. There was significant improvement in both high-pressure zone and asymmetry index, and these findings may explain the mechanism of action of the bulking agent injected.
Oliveira
Lucia C C
LC
Department of Anorectal Physiology, Policlínica Geral do Rio de Janeiro, Rio de Janeiro, Brazil. dralucia@uninet.com.br
Neves Jorge
José Marcio
JM
Yussuf
Sonia
S
Habr-Gama
Angelita
A
Kiss
Desidério
D
Cecconello
Ivan
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D001672:Biocompatible Materials / Q000008:administration & dosage*; D015331:Cohort Studies; D019160:Endosonography; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011788:Quality of Life; D012828:Silicones / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials; D012828:Silicones