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Anal physiology testing in fecal incontinence: is it of any value?

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Abstract

Introduction

The prognostic value of postoperative manometry in fecal incontinence is still controversial. The aims of this study were to establish if Fecal Incontinence Severity Index (FISI) and Fecal Incontinence Quality of Life Scale (FIQL) scores correlate with anal manometry and endoanal ultrasound findings and to define if there is any prognostic value in performing anal manometry after patients are surgically treated for fecal incontinence.

Methods

Fifty-three patients, all women, were identified. All patients underwent a surgical procedure and were analyzed pre- and postoperatively. Fecal incontinence was assessed using the FISI and FIQL. Patients who did not have these score were excluded. Manometry and ultrasound findings before treatment and manometry findings after treatment were compared with surgical patient’s incontinence scores. Anal canal length was noted, and its association with the pre- and postoperative manometry finding and incontinence scores were compared.

Results

No correlation of pre- and postoperative resting and squeeze pressures with incontinence scores was found. Ultrasound findings had no correlation with manometry results and incontinence scores. Anal canal length correlated with both pre- and postoperative manometry findings but not with incontinence scores.

Conclusion

Preoperative anal manometry and endoanal ultrasound help in guiding treatment options in patients with fecal incontinence. A decrease in FISI and increase in FIQL scores after a sphincter repair quantifies improvement after incontinence surgery, while changes in anal manometry pressures readings do not.

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Authors and Affiliations

  1. Department of Colorectal Surgery, A-30 Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Massarat Zutshi, Levilester Salcedo, Jeffrey Hammel & Tracy Hull

Authors
  1. Massarat Zutshi
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  2. Levilester Salcedo
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  3. Jeffrey Hammel
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  4. Tracy Hull
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Corresponding author

Correspondence to Massarat Zutshi.

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Funding

Department of Colorectal Surgery Research Funds and Cleveland Clinic Foundation, Cleveland, Ohio.

Author contribution

Massarat Zutshi: Project design, data analysis, data interpretation, and manuscript preparation

Levilester Salcedo: Data analysis, data interpretation, and manuscript preparation

Jeffery Hammel: Statistical analysis and manuscript editing

Tracy Hull: Project design, data interpretation, and manuscript editing

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Zutshi, M., Salcedo, L., Hammel, J. et al. Anal physiology testing in fecal incontinence: is it of any value?. Int J Colorectal Dis 25, 277–282 (2010). https://doi.org/10.1007/s00384-009-0830-z

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  • DOI: https://doi.org/10.1007/s00384-009-0830-z

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