Maximum anal sphincter strength measured by the solid sphere test and anal pressure profiles

Area of Science:

• Urology
• Gastroenterology
• Pelvic Floor Disorders

Background:

• Quantifying external anal sphincter function is crucial for diagnosing and managing fecal incontinence.
• Existing methods for assessing anal sphincter function vary in complexity and information yield.

Purpose of the Study:

• To compare the efficacy of two distinct methods for quantifying external anal sphincter function: anal pressure profiles and the solid sphere test.
• To determine the correlation between test results and the presence of fecal incontinence.

Main Methods:

• An open study was conducted involving 73 patients (63 women, 10 men) at Helsingborg Hospital, Sweden.
• Patients underwent assessment using anal pressure profiles and the solid sphere test.
• The study correlated test outcomes with the presence of incontinence, differentiating between continent and incontinent individuals.

Main Results:

• A strong correlation (r = 0.67, p < 0.001) was observed between maximum retained force and maximum anal squeeze pressure.
• Younger continent patients demonstrated significantly higher pressures than incontinent patients, though considerable overlap existed.
• Both assessment methods exhibited good reproducibility.

Conclusions:

• While the solid sphere test offers a quicker and simpler evaluation of external anal sphincter function, anal pressure profiles provide more comprehensive data.
• Anal pressure profiles are recommended for a more thorough evaluation of incontinence.