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Optimizing techniques for measuring anal resting and squeeze pressures with high-resolution manometry.

Nicholas R Oblizajek¹, Brototo Deb¹, Shivabalan Shiva Kathavarayan Ramu¹

¹Division of Gastroenterology and Hepatology, Clinical and Enteric Neuroscience Translational and Epidemiological Research Program (C.E.N.T.E.R.), Mayo Clinic, Rochester, Minnesota, USA.

Neurogastroenterology and Motility

|April 25, 2022

Summary

High-resolution manometry (HRM) can accurately measure anal pressures over 20 seconds. A single squeeze maneuver is likely sufficient for most patients, aiding in the diagnosis of fecal incontinence.

Keywords:

anal hypotonia dyssynergic defecation pelvic floor dysfunction

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Published on: April 17, 2019

Area of Science:

Gastroenterology
Pelvic Floor Disorders
Diagnostic Imaging

Background:

Optimal methods for measuring and analyzing anal resting and squeeze pressures using high-resolution manometry (HRM) remain unclear.
Accurate pressure measurements are crucial for diagnosing conditions like fecal incontinence and defecatory disorders.

Purpose of the Study:

To determine optimal measurement and analysis techniques for anal resting and squeeze pressures using HRM.
To compare pressure parameters between healthy women, women with defecatory disorders (DD), and women with fecal incontinence (FI).

Main Methods:

High-resolution manometry (HRM) was used to measure anal resting and squeeze pressures in 90 healthy women, 35 with DD, and 85 with FI.
Anal pressures were analyzed using Manoview™ software and a customized approach, comparing different measurement durations (20, 60, 300s) and squeeze maneuver analyses (5, 10, 15, 20s averages).

Main Results:

Women with FI exhibited lower anal resting pressure, squeeze pressure increment, and squeeze duration compared to healthy controls.
Resting pressures measured over 20, 60, and 300 seconds showed strong correlations in healthy and DD women.
A greater squeeze pressure increment was associated with a lower risk of FI, and one squeeze maneuver appeared sufficient for analysis.

Conclusions:

Anal resting and squeeze pressures can be accurately measured using HRM over a 20-second period.
A single squeeze maneuver is likely sufficient for most patient evaluations.
These findings provide standardized methods for HRM analysis in pelvic floor dysfunction.