Anal endosonography and manometry: comparison in patients with defecation problems

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Diagnostic Imaging

Background:

• Previous studies suggested correlations between anal sphincter function (manometry) and anatomy (ultrasound).
• These findings have not been consistently confirmed across different studies.
• Understanding this relationship is vital for diagnosing and managing anorectal disorders.

Purpose of the Study:

• To investigate the correlation between anal sphincter function measured by anorectal manometry and anal sphincter anatomy assessed by endoluminal ultrasound.
• To evaluate these correlations in a large cohort of patients with anorectal dysfunctions.
• To determine the complementary value of these diagnostic tools.

Main Methods:

• A series of 152 consecutive patients with anorectal dysfunctions underwent conventional multilumen anorectal manometry and endoanal sonography.
• Manometry assessed internal sphincter resting pressure and maximum external sphincter squeeze pressure.
• Endosonography measured internal anal sphincter (IAS) and external anal sphincter (EAS) diameters and integrity.

Main Results:

• Maximum squeeze pressure significantly correlated with EAS muscle thickness (P = 0.001).
• No association was found between resting pressure and IAS diameter.
• Women exhibited lower resting and squeeze pressures than men, but age-related changes were only significant for resting pressure. IAS and EAS dimensions correlated with age but not gender.

Conclusions:

• Anal manometry and anal ultrasound provide complementary information.
• Both diagnostic modalities are indicated for comprehensive evaluation of patients with anorectal problems.
• The weak correlations suggest that neither method alone is sufficient for complete assessment.