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Anorectal Manometry

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Pelvic Floor Disorders

Abstract

Anorectal manometry is considered a valuable test for the diagnosis and management of fecal incontinence. It is used to identify functional sphincter weakness, poor rectal compliance, and rectal sensation impairment. Anal resting pressure may be reduced in fecal incontinence, and dysfunction of the internal anal sphincter may be suspected in these patients. Maximal voluntary contraction is frequently impaired in incontinent patients and this sign is related to external anal sphincter dysfunction. A significant decrease or loss of rectal sensation may contribute to fecal incontinence by impairing the recognition of impending defecation, and substantial decreases in rectal compliance are associated with urge fecal incontinence. The rehabilitative treatment of fecal incontinence is guided by anorectal manometry, and the algorithm for multimodal rehabilitation is based on manometric reports. Furthermore, anorectal manometry can help to select candidates for overlapping sphincteroplasty, and identifies those patients with rectal prolapse who are at high risk for postoperative incontinence, modifying the surgical strategy of simple correction of prolapse. In conclusion, anorectal manometry offers decisive data for understanding the pathophysiology of fecal incontinence and can modify the therapeutic strategy.

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Author information

Authors and Affiliations

  1. Department of Medical and Surgical Critical Care, University of Firenze, Firenze, Italy

    Filippo Pucciani MD

Authors
  1. Filippo Pucciani MD
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Editor information

Editors and Affiliations

  1. Pelvic Floor Unit and Colorectal Service 1st Department of General Surgery, Regional Hospital, Treviso, Italy

    Giulio Aniello Santoro (Head) (Head)

  2. Department of Pediatric Radiology Children’s Teaching Hospital, Skubiszewski Medical University of Lublin, Lublin, Poland

    Andrzej Paweł Wieczorek

  3. Diagnostic Imaging, Princess Grace Hospital, London, UK

    Clive I. Bartram

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© 2010 Springer-Verlag Italia

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Pucciani, F. (2010). Anorectal Manometry. In: Santoro, G.A., Wieczorek, A.P., Bartram, C.I. (eds) Pelvic Floor Disorders. Springer, Milano. https://doi.org/10.1007/978-88-470-1542-5_40

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  • DOI: https://doi.org/10.1007/978-88-470-1542-5_40

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1541-8

  • Online ISBN: 978-88-470-1542-5

  • eBook Packages: MedicineMedicine (R0)

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