Abstract
PURPOSE: This study investigates the normal ultrasono graphic morphology of pelvic floor striated muscle and evaluates whether there are differences between males and females and between healthy subjects and patients with idiopathic fecal incontinence. METHODS: Manometric and ultrasonographic studies of the anal canal were performed in 30 healthy volunteers and in 26 patients with idiopathic fecal incontinence. Verification of ultrasonographic findings was obtained by studying anatomic preparations. RESULTS: Ultrasonography reliably identified the internal and external anal sphincter and frequently visualized neighboring structures. In addition, it detected muscular structures that have not clearly been described previously. However, differences in external sphincter function between males and females and between healthy subjects and incontinent patients were not reflected by alterations in muscle thickness. CONCLUSIONS: Endosonography of the anal canal clearly delineates muscular structures and may even visualize structures that have been previously incompletely defined. However, it remains to be shown that differences in certain muscular functions have a morphologic correlate that can be detected by endosonography.
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References
Mortensen N. Rectal and anal endosonography. Gut 1992;33:148–9.
Law PJ, Kamm MA, Bartram CI. A comparison between electromyography and anal endosonography in mapping external anal sphincter defects. Dis Colon Rectum 1990;33:370–3.
Cuesta MA, Meijer S, Derksen EJ, Boutkan H, Meuwissen SG. Anal sphincter imaging in fecal incontinence using endosonography. Dis Colon Rectum 1992;35:59–63.
Law PJ, Kamm MA, Bartram CI. Anal endosonography in the investigation of faecal incontinence. Br J Surg 1991;78:312–4.
Bartram CI, Burnett SJ. Atlas of anal endosonography. Oxford: Butterworth-Heinemann Ltd., 1991.
Eckardt VF, Elmer T. Reliability of anal pressure measurements. Dis Colon Rectum 1991;34:72–7.
Law PJ, Bartram CI. Anal endosonography: technique and normal anatomy. Gastrointest Radiol 1989;14: 349–53.
Loening-Baucke V, Anuras S. Effects of age and sex on anorectal manometry. Am J Gastroenterol 1985;80:50–3.
Read NW, Harford WV, Schmulen AC, Read MG, Santa Ana C, Fordtran JS. A clinical study of patients with fecal incontinence and diarrhea. Gastroenterology 1979;76:747–56.
Enck P, Kuhlbusch R, Lübke H, Frieling T, Erckenbrecht JF. Age and sex and anorectal manometry in incontinence. Dis Colon Rectum 1989;32:1026–30.
Felt-Bersma RJ, Klinkenberg-Knol EC, Meuwissen SG. Anorectal function investigations in incontinent and continent patients. Dis Colon Rectum 1990;33: 479–86.
Wormack NR, Morrison JF, Williams NS. The role of pelvic floor denervation in the aetiology of idiopathic fecal incontinence. Br J Surg 1986;73:404–7.
Lubowski DZ, Nicholls RJ, Burleigh DE, Swash M. Internal anal sphincter in neurogenic fecal incontinence. Gastroenterology 1988;95:997–1002.
Bartolo DC, Jarratt JA, Read MG, Donnelly TC, Read NW. The role of partial denervation of the puborectalis muscle in idiopathic fecal incontinence. Br J Surg 1983;70:664–7.
Kiff ES, Swash M. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg 1984;71:614–6.
Beersieck F, Parks AG, Swash M. Pathogenesis of anorectal incontinence: a histometric study of the anal musculature. J Neurol Sci 1979;42:111–27.
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Supported by Grant Ec 105/1-1 from the Deutsche Forschungsgemeinschaft.
This article includes parts of a doctoral thesis of Bernd Jung.
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Eckardt, V.F., Jung, B., Fischer, B. et al. Anal endosonography in healthy subjects and patients with idiopathic fecal incontinence. Dis Colon Rectum 37, 235–242 (1994). https://doi.org/10.1007/BF02048161
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DOI: https://doi.org/10.1007/BF02048161