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Is anorectal endosonography valuable in dyschesia?
S M Van Outryve1, M J Van Outryve, B Y De Winter
1Department of Gastroenterology and Hepatology, University Hospital of Antwerp, University of Antwerp, Belgium.
Gut
|October 16, 2002
Summary
Anorectal endosonography revealed that most patients with dyschesia exhibit abnormal anal sphincter and puborectalis muscle function during defecation attempts. This dysfunction, termed pelvic floor dyssynergia or anismus, is identifiable with this imaging technique.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Background:
- Dyschesia is characterized by inappropriate defecation movements.
- Dysfunction of the anal sphincter and puborectalis muscle can contribute to dyschesia.
Purpose of the Study:
- To demonstrate anal sphincter and puborectalis muscle dysfunction in dyschesia patients using anorectal endosonography.
Main Methods:
- Prospective study involving 20 dyschesia patients and 20 controls.
- Linear anorectal endosonography was performed to measure anal sphincter and puborectalis muscle dimensions.
- Measurements were taken at rest, during voluntary squeezing, and straining.
Main Results:
- 85% of patients showed paradoxical anal sphincter shortening/thickening during straining, compared to 35% of controls.
- 80% of patients exhibited paradoxical puborectalis muscle shortening/thickening during straining, versus 30% of controls.
- Statistically significant differences (p<0.01) were observed in both muscle groups between patients and controls.
Conclusions:
- Linear anorectal endosonography effectively demonstrates impaired relaxation of the anal sphincter and puborectalis muscle in dyschesia.
- This technique is valuable for diagnosing pelvic floor dyssynergia or anismus.