High resolution anorectal manometry in patients with anorectal dysfunctions and the therapeutic consequences

Česká verze

Authors: K. Košťálová; M. Zavoral; Š. Suchánek
Authors place of work: Interní klinika, 1. lékařská fakulta, Univerzita Karlova a Ústřední vojenská nemocnice – Vojenská fakultní nemocnice, Praha
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 1, s. 28-36.
Category: Původní práce
doi: https://doi.org/10.33699/PIS.2022.101.1.28–36

Summary

Introduction: High resolution anorectal manometry (HRAM) is a diagnostic method indicated in patients with anorectal dysfunction. The aim of the study was to evaluate the prevalence of anorectal dysfunctions and to assess therapeutic consequences.

Methods: Retrospective data of consecutive patients referred to HRAM in the period from March 2019 to February 2021 were evaluated. Basic manometric parameters were assessed: resting pressure (RP), maximal squeeze pressure (SP), rectal sensitivity (RS), and dyssynergic defecation (DD).

Results: 113 patients with combined fecal incontinence and obstructive defecation syndrome (FI + ODS: 44.2%), fecal incontinence (FI: 26.5%), obstructive defecation syndrome (ODS: 16.8 %), stoma before restoration of intestinal continuity (6.2%), functional pelvic pain (FP: 3.5 %) and controversial cases (2.7%) were analyzed. The average age was 54 years; female patients predominated (72 %). Patients with FI and FI+ODS had lower mean RP (57 mmHg and 53 mmHg) and/or lower SP (160 mmHg and 140 mmHg) compared to baseline. Patients with ODS had normal values of mean RP (75 mmHg) and SP (225 mmHg). DD was noted in most patients (FI: 76.6%, FI + ODS: 88%, ODS: 89.5%, FP: 100%). Conservative therapy with pelvic floor physiotherapy was provided in most cases (FI+ODS: 40%, ODS: 36.8%, FI: 13.3%, FP: 75%).

Conclusion: In patients with defecation disorders there is a high prevalence of pathological manometric findings that combine with each other. Based on manometric findings, conservative treatment with individual pelvic floor physiotherapy can be initiated.

Keywords:

anorectal manometry – anorectal dysfunction – pelvic floor physiotherapy

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