A study of the physiological variation in anal manometry

Abstract

The physiological variation in anal manometry using a perfused catheter with radiating sideholes was studied in 78 healthy volunteers. The maximum intraindividual variation in the length of the anal high pressure zone, resting pressure and squeeze pressure was 10 mm, 26 mmHg and 68 mmHg respectively. The median 95 per cent confidence interval for length of the pressure zone was 4 mm; for resting pressure it was 15 mmHg and for squeeze pressure it was 48 mmHg. Day-to-day variation did not exceed the intraindividual variation. Constant recording with the catheter fixed in the high pressure zone revealed slow waves and ultraslow waves with amplitudes of 6-24 mmHg which could account for most of the intraindividual variation. No sex difference was found in the length of the high pressure zone whereas resting pressure and squeeze pressure were higher in men than in women. Although a tendency towards a decrease in the length of the high pressure zone, resting pressure and squeeze pressure was observed with increasing age, no significant age-related difference could be demonstrated.

Left lateral position and common gynecologic examining position in anal manometry measurements for evaluation of urogynecologic patients

“…Among the various tests that are available, anorectal manometry is an essential clinical tool. Anorectal manometry has almost always been performed with the patient in the left lateral position (3,4). However, the left lateral position does not permit one to examine the pelvic organs properly and is not suitable for a urogynecologic evaluation.…”

Is Sacral Nerve Stimulation an Effective Treatment for Chronic Idiopathic Anal Pain?

“…Surgery, including sphincterotomy, does not improve symptoms. 16 A significant reduction in anal resting pressures following local application of nitroglycerin has been demonstrated by several authors, 17 but no studies have so far investigated the effects of nitroglycerin on chronic idiopathic anal pain. To achieve myorelaxation, botulinum toxin has been injected into the puborectalis muscle in patients with anismus 10 and in three patients with chronic idiopathic anal pain, producing positive results on four-month follow-up.…”

Overlap Technique Improves Results of Primary Surgery after Obstetric Anal Sphincter Tear

“…The technique used was "pull-through," with a water-filled catheter, according to the standard technique described previously. 37 The diameter of the catheter was 4 mm. Mean resting and squeeze pressures were measured and results analyzed by computer programs.…”