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Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study

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Abstract

Background

The aim of the study was to describe the results of 3D high-resolution anorectal manometry (3DHRAM) in a large cohort of patients with functional anorectal disorders.

Methods

In this single-center retrospective study, all consecutive patients referred for investigation of fecal incontinence (FI) or dyssynergic defecation (DD) underwent 3DHRAM. The parameters analyzed were usual manometric data, repartition of dyssynergic patterns, and the prevalence of a new “muscular subtype classification” underlying dyssynergia, anal sphincter defects, and pelvic floor disorders.

Results

Final analyses were performed in 1477 patients with a mean age 54 ± 16 years; 825 patients suffered from DD, and 652 patients suffered from FI. Among these patients, 86% met the diagnostic criteria for dyssynergia. Type II dyssynergia was the most frequently observed (56%) in women and men suffering from FI and in women with DD. Type I was the most frequently observed in men with DD (49%). Regarding the muscle type subgroups, combined puborectalis muscle involvement with an external anal sphincter profile was the most frequently observed. The global prevalence of rectal intussusception and excessive perineal descent were 12% and 21%, respectively. Type III dyssynergia was more frequently associated with pelvic floor disorders than were other types of dyssynergia (p < 0.001).

Conclusion

This large cohort study provides reference values for 3DHRAM in patients with functional anorectal disorders. Further studies are necessary to assess the prevalence of pelvic floor disorders in healthy volunteers and to develop new scores and classifications including all of these new parameters.

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Author information

Authors and Affiliations

  1. Gastroenterology Department, North Hospital, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Marseille, France

    Charlotte Andrianjafy, Camille Bazin, Michel Bouvier & Véronique Vitton

  2. Department of Gastroenterology, Instruction Hospital of French Army Laveran, Marseille, France

    Laure Luciano

  3. EA3279 Self-perceived Health Assessment Research Unit, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Marseille, France

    Karine Baumstarck

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  1. Charlotte Andrianjafy
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  2. Laure Luciano
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  3. Camille Bazin
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  4. Karine Baumstarck
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  5. Michel Bouvier
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  6. Véronique Vitton
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Contributions

CA performed the research, collected data, and wrote the paper.

LL performed the research and collected data.

CB performed the research and collected data.

KB conducted all statistical analyses.

MB performed the research, collected data, and wrote the paper.

VV designed the research study, performed the research, and wrote the paper.

Corresponding author

Correspondence to Véronique Vitton.

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VV, MB, and CA have been consultants for Medtronic.

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Andrianjafy, C., Luciano, L., Bazin, C. et al. Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study. Int J Colorectal Dis 34, 719–729 (2019). https://doi.org/10.1007/s00384-019-03235-z

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  • DOI: https://doi.org/10.1007/s00384-019-03235-z

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