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High resolution anorectal manometry in patients with anorectal dysfunctions and the therapeutic consequences

K Košťálová, M Zavoral, Š Suchánek

    Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
    |February 12, 2022
    PubMed

    Insights

    High resolution anorectal manometry (HRAM) reveals common anorectal dysfunctions like fecal incontinence and obstructive defecation syndrome. Conservative therapy, including pelvic floor physiotherapy, is often effective for these conditions.

    Area of Science:

    • Gastroenterology
    • Colorectal Surgery
    • Pelvic Floor Disorders

    Background:

    • High resolution anorectal manometry (HRAM) is a key diagnostic tool for evaluating patients with anorectal dysfunction.
    • Understanding the prevalence and interplay of these dysfunctions is crucial for effective patient management.

    Purpose of the Study:

    • To determine the prevalence of various anorectal dysfunctions using HRAM.
    • To assess the therapeutic outcomes and consequences based on manometric findings.

    Main Methods:

    • Retrospective analysis of 113 consecutive patients undergoing HRAM between March 2019 and February 2021.
    • Assessment of key manometric parameters: resting pressure (RP), maximal squeeze pressure (SP), rectal sensitivity (RS), and dyssynergic defecation (DD).

    Main Results:

    • Combined fecal incontinence and obstructive defecation syndrome (FI + ODS) was the most prevalent (44.2%), followed by FI (26.5%) and ODS (16.8%).
    • Patients with FI and FI+ODS exhibited lower resting and squeeze pressures.
    • Dyssynergic defecation was highly prevalent across all groups (76.6%-100%).

    Conclusions:

    • Defecation disorders frequently present with multiple, co-existing pathological manometric findings.
    • Individualized conservative treatment, particularly pelvic floor physiotherapy, is recommended based on HRAM results.
    Abstract

    Keywords:
    anorectal dysfunctionanorectal manometrypelvic floor physiotherapy

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