title: Anal sphincter complex muscles defects and dysfunction in asymptomatic parous women.
abstract: OBJECTIVE
  We aimed to determine anatomy and function of anal sphincter complex using three-dimensional ultrasound (3D-US) and manometry in asymptomatic parous women.
  
  
  METHODS
  3D-US of puborectalis muscle (PRM), external (EAS), and internal anal sphincters (IAS) anatomy was performed in 45 women without pelvic floor dysfunction. To assess function, rest and squeeze vaginal and anal pressures were measured. Based on 3D-US, subjects were divided into injured and uninjured groups.
  
  
  RESULTS
  Forty-four of 45 subjects had adequate PRM images. The injured PRM (N = 14) group had significantly lower vaginal pressures as compared with uninjured PRM group (N = 30; p = 0.001). Four of 45 subjects with IAS and EAS defects had lower resting and squeeze anal canal pressure. Muscle injury to IAS, EAS and PRM in the same individual was uncommon.
  
  
  CONCLUSIONS
  In asymptomatic parous women, PRM defects were more common than the EAS/IAS defects but defects in more than one muscle were infrequent. Subjects with injured PRM had low vaginal pressure than the ones without.
authors: The Pelvic Floor Function and Disorder Group, University of California, San Diego, CA, USA.
authors: Milena M
authors: MM
authors: Weinstein
authors: Dolores H
authors: DH
authors: Pretorius
authors: Sung-Ae
authors: SA
authors: Jung
authors: Jennifer J
authors: JJ
authors: Wan
authors: Charles W
authors: CW
authors: Nager
authors: Ravinder K
authors: RK
authors: Mittal
references: Obstet Gynecol. 2006 Oct;108(4):863-72
references: 17012447
references: Int Urogynecol J Pelvic Floor Dysfunct. 2008 May;19(5):633-6
references: 17999021
references: Am J Obstet Gynecol. 2007 Jul;197(1):52.e1-7
references: 17618755
references: Am J Obstet Gynecol. 2007 Dec;197(6):636.e1-6
references: 18060960
references: Am J Obstet Gynecol. 2007 Jul;197(1):68.e1-6
references: 17618762
references: Obstet Gynecol. 2007 Feb;109(2 Pt 1):295-302
references: 17267827
references: Br J Surg. 2003 Nov;90(11):1333-7
references: 14598410
references: Gastroenterology. 2002 Jan;122(1):5
references: 11781273
references: Am J Physiol Gastrointest Liver Physiol. 2008 Aug;295(2):G367-73
references: 18599590
references: Ultrasound Obstet Gynecol. 2007 Feb;29(2):195-204
references: 17219371
references: Neurourol Urodyn. 2005;24(3):243-7
references: 15714439
references: Neurourol Urodyn. 1995;14(2):131-9
references: 7780440
references: Dis Colon Rectum. 1999 Dec;42(12):1525-32
references: 10613469
references: Neurourol Urodyn. 2004;23(7):662-7
references: 15382182
references: Gut. 2005 Apr;54(4):546-55
references: 15753542
references: Clin Gastroenterol Hepatol. 2009 Feb;7(2):205-11
references: 18996750
references: Am J Physiol Gastrointest Liver Physiol. 2007 Feb;292(2):G565-71
references: 17023551
references: Obstet Gynecol. 2003 Jan;101(1):46-53
references: 12517644
references: Ultrasound Obstet Gynecol. 2007 Aug;30(2):201-9
references: 17605148
references: Obstet Gynecol. 2005 Oct;106(4):774-81
references: 16199635
references: Obstet Gynecol. 2005 Oct;106(4):707-12
references: 16199625
references: N Engl J Med. 1993 Dec 23;329(26):1905-11
references: 8247054
references: Gastroenterology. 1976 Aug;71(2):263-7
references: 939387
references: Gastroenterology. 2003 May;124(6):1672-85
references: 12761725
references: Neurourol Urodyn. 2004;23(2):134-42
references: 14983425
references: Gastroenterol Clin North Am. 2008 Sep;37(3):493-509, vii
references: 18793993
references: Gastroenterology. 2002 Nov;123(5):1441-50
references: 12404218