TITLE

Influence of rectal prolapse on the asymmetry of the anal sphincter in patients with anal incontinence

AUTHOR(S)
Damon, Henri; Henry, Luc; Roman, Sabine; Barth, Xavier; Mion, François
PUB. DATE
January 2003
SOURCE
BMC Gastroenterology;2003, Vol. 3, p23
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Anal sphincter defects have been shown to increase pressure asymmetry within the anal canal in patients with fecal incontinence. However, this correlation is far from perfect, and other factors may play a role. The goal of this study was to assess the impact of rectal prolapse on anal pressure asymmetry in patients with anal incontinence. Methods: 44 patients, (42 women, mean age: 64 (11) years), complaining of anal incontinence, underwent anal vector manometry, endo-anal ultrasonography (to assess sphincter defects) and pelvic viscerogram (for the diagnosis of rectal prolapse). Resting and squeeze anal pressures, and anal asymmetry index at rest and during voluntary squeeze were determined by vector manometry. Results: Ultrasonography identified 19 anal sphincter defects; there were 9 cases of overt rectal prolapse, and 14 other cases revealed by pelvic viscerogram (recto-anal intussuception). Patients with rectal prolapse had a significantly higher anal sphincter asymmetry index at rest, whether patients with anal sphincter defects were included in the analysis or not (30 (3) % versus 20 (2) %, p < 0.005). Among patients without rectal prolapse, a higher anal sphincter asymmetry index during squeezing was found in patients with anal sphincter defects (27 (2) % versus 19 (2) %, p < 0.03). Conclusions: In anal incontinent patients, anal asymmetry index may be increased in case of anal sphincter defect and/or rectal prolapse. In the absence of anal sphincter defect at ultrasonogaphy, an increased anal asymmetry index at rest may point to the presence of a rectal prolapse.
ACCESSION #
28834216

 

Related Articles

  • Complications and reoperations in stapled anopexy: learning by doing. Jongen, Johannes; Bock, Jens-Uwe; Peleikis, Hans-Günter; Eberstein, Anne; Pfister, Karin // International Journal of Colorectal Disease;Mar2006, Vol. 21 Issue 2, p166 

    Although stapled anopexy for second and third degree hemorrhoids has been widely used since 1998, there are limited long-term data available. We performed an analysis of a prospectively accrued data set of all patients undergoing stapled anopexy in our practice from 1998 through August 2003....

  • Erratum to: Sacral neuromodulation for faecal incontinence: is the outcome compromised in patients with high-grade internal rectal prolapse? Prapasrivorakul, Siriluck; Gosselink, Martijn; Gorissen, Kim; Fourie, Simona; Hompes, Roel; Jones, Oliver; Cunningham, Chris; Lindsey, Ian // International Journal of Colorectal Disease;Feb2015, Vol. 30 Issue 2, p235 

    A correction to the article "Sacral neuromodulation for faecal incontinence: is the outcome compromised in patients with high-grade internal rectal prolapse?" is presented.

  • Clinical and functional outcome of laparoscopic posterior rectopexy (Wells) for full-thickness rectal prolapse. A prospective study. Dulucq, Jean-Louis; Wintringer, Pascal; Mahajna, Ahmad // Surgical Endoscopy;Dec2007, Vol. 21 Issue 12, p2226 

    Background: Laparoscopic rectopexy offers the advantages of the open transabdominal approach while decreasing the surgical comorbidity. The aim of this prospective study was to assess the clinical and functional outcome of laparoscopic Wells procedure for full-thickness rectal...

  • No Surgery for Full-Thickness Rectal Prolapse: What Happens with Continence? Cunin, Diane; Siproudhis, Laurent; Desfourneaux, Véronique; Berkelmans, Isabelle; Meunier, Bernard; Bretagne, Jean-François; Bouguen, Guillaume // World Journal of Surgery;Jun2013, Vol. 37 Issue 6, p1297 

    Background: Surgery is the only validated means of treating overt rectal prolapses, but both patients and physicians may decline or postpone the surgical approach. However, little is known on the functional outcome of nonoperated rectal prolapse. The aim of the present study was to highlight the...

  • Solitary rectal ulcer syndrome: physiology and treatment options. Swatton, Anna // British Journal of Nursing;11/26/2009, Vol. 18 Issue 21, p1312 

    Solitary rectal ulcer syndrome (SRUS) is a rare condition that can lead to pain, rectal bleeding and mucus. It is associated with chronic straining and abnormal defaecatory behaviour, including digitating and several unsuccessful visits to the toilet daily. Other symptoms can include tenesmus,...

  • Sacral neuromodulation for faecal incontinence: is the outcome compromised in patients with high-grade internal rectal prolapse? Prapasrivorakul, Siriluck; Gosselink, Martijn; Gorissen, Kim; Fourie, Simona; Hompes, Roel; Jones, Oliver; Cunningham, Chris; Lindsey, Ian // International Journal of Colorectal Disease;Feb2015, Vol. 30 Issue 2, p229 

    Background: High-grade internal rectal prolapse appears to be one of the contributing factors in the multifactorial origin of faecal incontinence. Whether it affects the outcome of sacral neuromodulation is unknown. We compared the functional results of sacral neuromodulation for faecal...

  • Laparoscopic Ventral Rectopexy for Internal Rectal Prolapse Using Biological Mesh: Postoperative and Short-Term Functional Results. Sileri, Pierpaolo; Franceschilli, Luana; Luca, Elisabetta; Lazzaro, Sara; Angelucci, Giulio; Fiaschetti, Valeria; Pasecenic, Carolina; Gaspari, Achille // Journal of Gastrointestinal Surgery;Mar2012, Vol. 16 Issue 3, p622 

    Background: Laparoscopic ventral mesh rectopexy is a novel procedure to correct internal and external rectal prolapse. Several authors have shown that this approach is safe and improves obstructive defaecation symptoms and faecal incontinence, without inducing new-onset constipation, possible...

  • Colon and Anorectum - Benign Colorectal.  // Gut;2015 Supplement1, Vol. 64, pA159 

    The article presents abstracts on colon and anorectum including use of antegrade continence enema (ACE) for treatment of faecal incontinence (FI), laparoscopic Protack rectopexy (LPR) for management of full thickness rectal prolapse (FTRP) and outcome of acute diverticulitis.

  • Anal vector volume analysis: an effective tool in the management of pelvic floor disorders. Grande, M.; Cadeddu, F.; Sileri, P.; Ciano, P.; Attinà, G.; Selvaggio, I.; Milito, G. // Techniques in Coloproctology;Mar2011, Vol. 15 Issue 1, p31 

    Introduction: Different trials have investigated the role of conventional anal manometry in the diagnosis of pelvic floor disorders. The aim of the present study is to define the role and the effectiveness of vector anal manometry and vector asymmetry index scoring in the assessment of pelvic...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics