Anal canal anatomy showed by three-dimensional anorectal ultrasonography

Regadas, Francisco Sérgio Pinheiro; Murad-Regadas, Sthela M.; Lima, Doryane Maria dos Reis; Silva, Flavio R.; Barreto, Rosilma Gorete Lima; Souza, Marcellus H.; Filho, Francisco L. de Caldas

doi:10.1007/s00464-007-9339-0

Cited by 85 publications

(80 citation statements)

References 12 publications

(17 reference statements)

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“…According to Dietz et al (6,7) true rectocele is a rectovaginal septum defect in younger nulliparous women, the prevalence and size of which appear to be associated with childbirth. Regadas et al (21) clearly demonstrated gender-specific differences in anal canal anatomy. Thus, the anterior external anal sphincter is shorter and the gap is longer in females, possibly accounting for the higher incidence of pelvic floor dysfunctions in this gender.…”

Section: Resultsmentioning

confidence: 96%

Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Murad-Regadas

Regadas

Rodrigues

et al. 2011

Arq. Gastroenterol.

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-Context -The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. Objectives -To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. Methods -Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (≤50y x >50y) and stratified by mode of delivery and parity: group I (≤50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 -nulliparous (n = 135), 1 -vaginal (n = 46), >1 -vaginal (n = 166). Results -Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group ≤50y and in the nulliparous and vaginal groups >50y. No correlation was found between rectocele and the number of vaginal deliveries. Conclusion -Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

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Section: Resultsmentioning

confidence: 96%

Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Murad-Regadas

Regadas

Rodrigues

et al. 2011

Arq. Gastroenterol.

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“…Two-dimensional ultrasonography is limited by the single plane of view and can be used to measure the extent of the defect circumferentially (radial angle in degrees or in hours of the clock) (3,6,8,20,21) . The recent development of 3-DAUS using 360° field-of-view transducers provides a topographical overview of anal canal anatomy and allows measurement of length, thickness, area of sphincter defect in the sagittal and coronal planes, and volume of sphincter damage (18,22,24,27) . Few studies have reported on the contribution of this modality in the evaluation of anal canal anatomy in patients with fecal incontinence (18,24,26,27) .…”

Section: Discussionmentioning

confidence: 99%

“…The recent development of 3-DAUS using 360° field-of-view transducers provides a topographical overview of anal canal anatomy and allows measurement of length, thickness, area of sphincter defect in the sagittal and coronal planes, and volume of sphincter damage (18,22,24,27) . Few studies have reported on the contribution of this modality in the evaluation of anal canal anatomy in patients with fecal incontinence (18,24,26,27) . In previous reports, we have demonstrated the asymmetrical shape of the anal canal and compared anal sphincter positions and lengths between the sexes (18) The anterior EAS and the IAS have been described as shorter in women, producing a longer gap with a less resistant upper anal canal TABLE 5.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have reported on the contribution of this modality in the evaluation of anal canal anatomy in patients with fecal incontinence (18,24,26,27) . In previous reports, we have demonstrated the asymmetrical shape of the anal canal and compared anal sphincter positions and lengths between the sexes (18) The anterior EAS and the IAS have been described as shorter in women, producing a longer gap with a less resistant upper anal canal TABLE 5. Correlation between anterior external anal sphincter and anal pressure measurements on anorectal manometry in patients had sphincter defects (EAS defect plus combined EAS and IAS defects) and had intact sphincters…”

Section: Discussionmentioning

confidence: 99%

“…Resting (14,18) . In this study, we evaluated changes in the anatomy of the anal canal in symptomatic women after vaginal delivery and assessed potential correlations with continence scores and anorectal manometry pressures.…”

Section: Eas Defect Plus Eas + Ias Defect (N = 33) Anterior Ias (Cm) Vsmentioning

confidence: 99%

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Do Changes in Anal Sphincter Anatomy Correlate With Anal Function in Women With a History of Vaginal Delivery?

Murad-Regadas

Dealcanfreitas

Regadas

et al. 2014

Arq. Gastroenterol.

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-Objectives -To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods -Female with fecal incontinence and vaginal delivery were assessed with Wexner's score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Results -Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions -Fecal incontinence symptoms did not correlate with anal pressures and anal sphincter anatomy changes, but women with sphincter defects have shorter anterior EAS and IAS and a longer gap.

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Three‐Dimensional Endoanal Ultrasound Features of the Anal Sphincter in Asian Primigravidae

Wickramasinghe

Senaratne

Senanayake

et al. 2018

J of Ultrasound Medicine

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Anal canal anatomy showed by three-dimensional anorectal ultrasonography

Cited by 85 publications

References 12 publications

Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

Do Changes in Anal Sphincter Anatomy Correlate With Anal Function in Women With a History of Vaginal Delivery?

Three‐Dimensional Endoanal Ultrasound Features of the Anal Sphincter in Asian Primigravidae

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