scholarly journals O27 The diameter of an anorectal physiology catheter in the anal canal influences the results

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
C M Byrne ◽  
E S Kiff ◽  
A Sharma ◽  
K J Telford
Keyword(s):  
Anal Canal ◽  
Anorectal Manometry ◽  
Anorectal Physiology ◽  
Anal Physiology ◽  
Opening Pressure ◽  
Linear Fashion ◽  
Anorectal Dysfunction ◽  
Rigid Tube ◽  
Resting Pressure

Abstract Introduction Conventional “catheter-based” anorectal physiology systems may influence anal canal pressures by stretching the sphincters thereby increasing tension. Anal acoustic reflectometry (AAR) is a “catheter-less” technique as the flexible thin catheter does not distort the anal canal. The aim of this study was to explore whether the size of rigid tube in the anal canal had any effect on tension. Method Participants with no anorectal dysfunction were included. Baseline resting/squeeze AAR measurements were recorded, then repeated with a 6 mm and 10 mm rigid tube placed along-side the AAR catheter. This process was repeated for anorectal manometry (ARM) and Opening pressure (AAR) and mean resting pressure (MRP) were used to calculate tension (pressure (mmHg) x radius (mm)). Result 9 participants were included (7 female/2male) with median age 22 years (21–31 years). Tension at rest (no additional tube) for AAR and ARM was 14 and 135 N/m respectively and 33 and 238 N/m during squeeze. Tension increased in a linear fashion, for both resting and squeeze, as the size of additional rigid tube increased. The largest increase in tension from baseline AAR and ARM measurements was recorded with the 10 mm additional tube (1,807% and 102% respectively). Conclusion The thin AAR catheter exerted the lowest tension at baseline. A large increase in tension was observed as the size of tube increased and therefore the diameter of catheter used in the assessment of anal physiology will affect the results. ARM measurements carried out by devices of different diameter will not be comparable. Take-home Message The diameter of the anorectal physiology catheter in the anal canal influences the results.

Treatment fecal incontinence in children with bulking agents «DAM+»

2014 ◽  
Vol 5 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Igor Alekseyevich Komissarov ◽  
Viktoriya Aleksandrovna Glushkova ◽  
Nadezhda Georgiyevna Kolesnikova
Keyword(s):  
Fecal Incontinence ◽  
Anal Canal ◽  
Anal Manometry ◽  
Internal Sphincter ◽  
Bulking Agents ◽  
Significance Level ◽  
Neurogenic Fecal Incontinence ◽  
Before And After ◽  
Resting Pressure ◽  
Average Quantity

One of the reason of organic and neurogenic fecal incontinence in children is low resting pressure in the anal canal. In functional aspect, one of the main roles plays internal sphincter of the anal canal that provides 50-85 % of basal resting pressure and close of the anal canal. Purposes. The purpose of this article is to study the possibilities of using bulking agent «DAM+» to increase resting pressure in the anal canal in children with fecal incontinence, and evaluate the results of this treatment. Metods. The study has been performed in the Department of Pediatric Surgery in our university since 2007 for 2013. In total, 35 patients, aged 2-18 with organic or neurogenic fecal incontinence were underwent 57 procedure of introduction polyacrylamid gel «DAM+». Patients with overflow fecal incontinence were excluded. Before treatment and after, all patients were assessed clinical examination and anal manometry. Anal manometry was perfomed оn multifunctional apparatus «Menfis 2000». Results. The average quantity of resting pressure in the anal canal before operation is formed 20.98 ± 5.17 сm. (H2O), after operation 32.62 ± 6.63 сm. (H2O), in long-term period 28.07 ± 6.65 сm. (H2O) Conclusion. The clinical efficiency of procedure correlates with values of resting pressure in the anal canal before and after treatment. Implantation of «DAM+» into submucosal layer provides increasing of basal resting tone in the anal canal. Imitation of work of the internal anal sphincter and expansive vascular anal cushions on the other part, prevents patulous anus and provides a hermetic seal, that responds for close anal walls. Statistical data was shown, that the average quantity of resting pressure in the anal canal before operation and after operation has performed at the 5 % significance level. P-values < 0.05 was considered statistically significant.

scholarly journals ANORECTAL MANOMETRY STANDARD OF A BRAZILIAN POPULATION AT PRODUCTIVE AGE WITHOUT PELVIC FLOOR DISORDERS: A PROSPECTIVE VOLUNTEERED STUDY

2021 ◽  
Vol 34 (1) ◽  
Author(s):  
Rodrigo Ambar PINTO ◽  
Isaac José Felippe CORREA-NETO ◽  
Leonardo Alfonso BUSTAMANTE-LOPEZ ◽  
Caio Sergio R. NAHAS ◽  
Carlos Frederico S. MARQUES ◽  
...  
Keyword(s):  
Anal Canal ◽  
Pelvic Floor ◽  
Anorectal Manometry ◽  
Pelvic Floor Disorders ◽  
Average Length ◽  
Male Gender ◽  
Sphincter Pressure ◽  
Male And Female ◽  
Functional Anal ◽  
Normal Standards

ABSTRACT Background: Due to the lack of normal standards of anorectal manometry in Brazil, data used are subject to normality patterns described at different nationalities. Aim: To determine the values and range of the parameters evaluated at anorectal manometry in people, at productive age, without pelvic floor disorders comparing the parameters obtained between male and female. Methods: Prospective analysis of clinical data, such as gender, age, race, body mass index (BMI) and anorectal manometry, of volunteers from a Brazilian university reference in pelvic floor disorders. Results: Forty patients were included, with a mean age of 45.5 years in males and 37.2 females (p=0.43). According to male and female, respectively in mmHg, resting pressures were similar (78.28 vs. 63.51, p=0.40); squeeze pressures (153.89 vs. 79.78, p=0.007) and total squeeze pressures (231.27 vs. 145.63, p=0.002). Men presented significantly higher values of anorectal squeeze pressures, as well as the average length of the functional anal canal (2.85 cm in male vs. 2.45 cm in female, p=0.003). Conclusions: Normal sphincter pressure levels in Brazilians differ from those used until now as normal literature standards. Male gender has higher external anal sphincter tonus as compared to female, in addition a greater extension of the functional anal canal

scholarly journals HIGH-RESOLUTION ANORECTAL MANOMETRY IN TESTING ANORECTAL FUNCTION AFTER COMBINATION TREATMENT FOR RECTAL CANCER

2020 ◽  
Vol 66 (4) ◽  
pp. 385-390
Author(s):  
Oleg Kit ◽  
Yuriy Gevorkyan ◽  
Natalya Soldatkina ◽  
Yevgeniy Kolesnikov ◽  
Mikhail Averkin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Surgical Treatment ◽  
Combination Treatment ◽  
Anorectal Manometry ◽  
External Sphincter ◽  
Anorectal Function ◽  
Lars Score ◽  
Resting Pressure ◽  
Anal Resting Pressure

The purpose of the study was to evaluate anorectal function with high-resolution anorectal manometry in patients receiving combination treatment for rectal cancer. Material and methods. We analyzed literature data (PubMed, Scopus, eLIBRARY databases) and our treatment outcomes in 50 rectal cancer patients receiving combination or surgical treatment at Rostov Research Institute of Oncology. Results. The mean anal resting pressure was 1.8 times lower, and the maximal anal squeeze pressure was 1.5 times lower in patients after combination treatment, compared to surgical treatment (p<0.05). 3 months after combination treatment with prolonged radiotherapy, contractile properties of the internal sphincter were decreased in 83.3%, of the external sphincter - in 26.7% of patients. Fatigue rate of external sphincter muscles was increased in 17 (56.7%) patients of this group. We observed a correlation between some anorectal manometry data and the LARS score: in both groups, patients with the maximal LARS score showed the lowest mean anal resting pressure, compared to patients with minimal and average LaRs scores (p<0.05). Conclusion. Due to negative effect of radiation therapy on the anorectal function, careful selection of patients who will benefit from radiation therapy is very important, as well as identification of patients with a high risk of radiation-induced functional problems and development of rehabilitation programs for patients treated for rectal cancer.

scholarly journals 1. Clinical Studies of Resting Pressure and Rhythmical Activity of the Anal Canal in Patients with Anal Diseases

1981 ◽  
Vol 34 (2) ◽  
pp. 59-63,153 ◽  
Author(s):  
T. Hashimoto ◽  
M. Katsumi ◽  
S. Ura ◽  
K. Matsumoto ◽  
K. Ieda ◽  
...  
Keyword(s):  
Anal Canal ◽  
Clinical Studies ◽  
Rhythmical Activity ◽  
Resting Pressure

scholarly journals Brief communication (Original). Anorectal physiology evaluation after male-to-female sex reassignment surgery

2014 ◽  
Vol 8 (6) ◽  
Author(s):  
Pornthep Pungrasmi ◽  
Jiraroch Meevassana ◽  
Kassaya Tantiphlachiva ◽  
Poonpissamai Suwajo ◽  
Apichai Angspatt ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Anorectal Manometry ◽  
Anorectal Physiology ◽  
Double Layers ◽  
Sex Reassignment Surgery ◽  
Sex Reassignment ◽  
Rectal Sensation ◽  
Female Sex ◽  
Before And After ◽  
Male To Female

AbstractBackground: Male-to-female sex reassignment surgery (MTF-SRS) is a treatment for gender identity disorders (GID) wherein the penis is removed and an epithelialized neovagina is created in the retroprostatic or rectovesical space. This is a space between the double layers of Denonvilliers’ fascia that contains motor, sensory, and autonomic nerves to the pelvic organs. Injury to these nerves may lead to anorectal dysfunction. However, there has been no objective study of anorectal physiologic changes after SRS.Objectives: To compare anorectal physiological parameters, before and after, male-to-female sex reassignment surgery (SRS) and to evaluate the effects of SRS on anorectal physiology.Methods: In 10 patients with MTF GID who underwent SRS at King Chulalongkorn Memorial Hospital, anorectal manometry was performed using a water perfused catheter (Mui Scientific, Ontario, Canada) and a state-of-the-art anorectal manometry system (Medtronic, Minneapolis, MN, USA) at the Gastrointestinal Motility Research Unit at 2 weeks before and 3 months after the SRS. Data were analyzed using PolygramNet software. Anal sphincter pressures (mmHg) with volume used to elicit rectal sensation (mL).Results: There was no significant change in the resting anal sphincter pressure, anal sphincter squeezing pressure, sustained squeezing pressure, and duration of squeeze, rectal sensation, and threshold of the desire to defecate affected by SRS. Cough reflex and rectoanal inhibitory reflex were normal both before and after SRS in all patient participants.Conclusions: Sex reassignment surgery seems to produce no effect on clinical anorectal functions. This was proven by absence of clinically significant changes in anorectal manometry.

scholarly journals Anorectal function and quality of life after chemoradiotherapy in patients with anal canal carcinoma

2017 ◽  
Vol 5 (2) ◽  
pp. 33-38
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Gloria Bernardi ◽  
Lavinia Grapulin ◽  
Alessio Impagnatiello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Anal Canal ◽  
Anorectal Manometry ◽  
Anorectal Function ◽  
Anal Canal Cancer ◽  
European Organization ◽  
Patient Reported ◽  
Sphincter Complex

Background: A retrospective study was conducted to evaluate sphincter function and quality of life (QoL) in patients treated with radiotherapy and concurrent chemotherapy (CRT) for anal canal cancer. Materials and Methods: From 1998 to 2010, patients with anal canal cancer treated with CRT were eligible. Radiation dose was 59.4 Gy (1.8 Gy/ fraction) and the chemotherapy regimen was 5-fluorouracil and mitomycin C. Anorectal function was investigated by anorectal manometry and transrectal ultrasound. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C29 questionnaire. Correlations between diagnostic parameters and patient-reported outcomes were evaluated. Results: Eighteen patients were enrolled. Overall, 4 patients had stage I disease, 8 stage II and 6 stage III. Anorectal manometry parameters were significantly lower compared to healthy scores. Patients-reported continence was significantly higher than fecal incontinence manometry scores. Ultrasound sphincter complex defects were recorded in 17 patients. Globally, a positive correlation was described between resting pressure of manometric exam and sexual functioning items and sphincter complex and patient-reported flatulence, respectively. Conclusions: Definitive CRT represents the standard of care for anal canal cancer. Patients experienced low rates of fecal incontinence compared with results of diagnostic exams. Further studies are needed to better define toxicity and QoL after definitive CRT in anal canal cancer.

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