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[Anal endoluminal endosonography in the study of fecal incontinence]
J M Ramírez Rodríguez1, N J Mortensen, M M Smilgin Humphreys
1Departmento de Cirugía Colorrectal, Hospital Universitario John Radcliffe, Oxford, Reino Unido.
Objective:
Classically, clinical assessment of faecal incontinence is supported by anal manometry and electromyography. Recently, anal endosonography has appeared to be the ideal method evaluating anatomically both the internal and external anal sphincter. In this paper, our experience in evaluating faecal incontinence by anal endosonography is presented.
Patients:
34 patients (26 female, 4 male; mean age, 40) complaining of faecal incontinence were analysed by traditional anorectal physiologic tests as well as by anal endosonography. Previously, patients were clinically grouped in: group 1, post-delivery, 18 cases; group 2, post-surgery, 6 cases; group 3, "idiopathic", 10 cases.
Results:
Results of anal physiologic test showed significant differences between group 1 and the rest of patients. All patients complaining of post-surgery incontinence were found to have sphincter disruptions. 2 out of 10 patients from group 3 presented unsuspected lesions. Nearly 40% of women with post-delivery incontinence had normal anal muscles.
Conclusions:
Anal endosonography is a imaging technique that permits fully vision of the sphincters. It showed to be a great help in cases of faecal incontinence particularly in the decision-making of surgical approach.