Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects

Ríos, Constanza Ciriza de los; Juan, Antonio Ruiz de León San; Garcı́a, M. Teresa; Moros, E.; Duran, Fernando; Yagüe, Teresa Muñoz; Rodríguez-Valcárcel, Fernando Canga; Cámara, Agustı́n Gómez de la; Tortajada, G Castellano

doi:10.4321/s1130-01082010001200002

Cited by 9 publications

(10 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The precise pathophysiological mechanism why the procedure is effective is unknown, and this may be seen in the medical literature for a variety of anorectal manometry values, both pre-and post-operatively, where various irreproducible effects are described for all series: increased maximum tolerated volume, increased volume at which sensation takes place, and increased sphincter resting pressure (18)(19)(20)(21). In our study, following the procedure we saw that voluntary contraction pressure improved in a statistically significant manner.…”

Section: Discussionmentioning

confidence: 52%

Sacral nerve stimulation for fecal incontinence

Pascual

Ortega

et al. 2011

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Objective: to analyze short-term outcomes and complications for our first fifty patients with fecal incontinence undergoing sacral root stimulation.Patients: fifty patients with fecal incontinence receiving sacral neuromodulation in 4 hospitals are reviewed. Discussed variables include: age, sex, incontinence duration, incontinence cause, prior surgery for incontinence, Wexner scale score, anorectal manometry parameters, and endoanal ultrasonographic findings. Following the procedure Wexner scale score, anorectal manometry parameters, and associated complications are reviewed.Results: mean age of patients is 59.9 years, with females predominating. Most common causes of incontinence include obstetric procedures, idiopathic origin, and prior anal surgery. Mean followup is 17.02 months. Follow-up revealed a statistically significant reduction in Wexner scale score and increase in voluntary anal pressure. Technique-derived minor complications included: 2 surgical wound infections that led to stimulator withdrawal; 2 patients with pain who were managed conservatively; 1 case of externalization in a gluteal stimulator; and 1 broken tetrapolar electrode.Conclusions: sacral nerve stimulation is a simple technique that improves Wexner scores in a statistically significant manner with a low complications rate.Key words: Fecal incontinence. Anal sphincter. Anorectal manometry. INTRODUCTIONSacral nerve stimulation in the management of fecal incontinence has led to a change in the diagnostic and therapeutic algorithm for this disease in recent years (1-5). This treatment modality so far removed from the common practice of general surgeons has forced coloproctology specialists to undergo specific education on the technique's theoretical and practical aspects in order to treat their patients.The procedure's absolute indication in fecal incontinence was initially focused on incontinent patients showing integrity of the sphincteric apparatus because of no previous lesions (idiopathic incontinence) or because of a prior sphincteroplaty procedure losing efficacy over time (incontinence most often resulting from obstetric trauma or prior surgery). Its indication has been gradually extended to patients with sphincteric defects (6-10), hence there is an ever increasing number of incontinent patients that are eligible for this procedure, also including stimulators indicated for constipation (11) and pain (12). As with all surgical skills, neuromodulation also displays a learning curve that may be shortened with workshops on stimulators and cadaveric training but cannot be obviated. The goal of this study was to analyze the first fifty cases by three general surgeon teams who used sacral root stimulations for the management of fecal incontinence, and to review the procedure's difficulties and short-term outcomes and complications. MATERIAL AND METHODSThe first fifty patients with fecal incontinence treated with sacral nerve stimulation in four Madrid sites from 2004 to 2009 are retrospectively reviewed. All patients are adults (older t...

show abstract

Section: Discussionmentioning

confidence: 52%

Sacral nerve stimulation for fecal incontinence

Pascual

Ortega

et al. 2011

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

show abstract

“…However, the difference in the median resting pressure measured in the erect position from that in the left-lateral position was only 7–8 cm H 2 O in either the CRAI or non-CRAI patients, which would be clinically insignificant to avoid FI especially in the CRAI patients, because the median squeeze pressure was nearly 30 cm H 2 O lower in the erect position than the lateral position. Anal canal length in the lateral position was longer in healthy subjects compared with female patients with FI in previous studies [ 23 , 24 ]. Meanwhile, there was no change in the anal canal length with a change in the posture in the healthy adults [ 9 ].…”

Section: Discussionmentioning

confidence: 69%

“…Besides patients with FI, those with non-prolapsing hemorrhoids also have a thicker anal cushion and, thus, a higher resting pressure [18]. Anal canal length in the lateral position was greater in healthy subjects compared with female patients with FI in previous studies [19,20]. Meanwhile, there was no change in the anal canal length with a change in the posture in the healthy adults [9].…”

Section: Discussionmentioning

confidence: 99%

Effect of posture on anorectal manometric measurements in female patients with fecal incontinence and rectoanal intussusception

2022

View full text Add to dashboard Cite

Purpose This study aimed to investigate the influence of erect position on anorectal manometry in patients with rectoanal intussusception (RAI). Methods This was a single center prospective observational study. Eighty female patients with fecal incontinence (FI) who underwent defecography between 1st January 2016 and 30th April 2022 were included. The effect of posture on commonly measured parameters during manometry was assessed in the left-lateral and erect positions. The severity of FI was assessed using FI Severity Index (FISI). Results Defecography showed that 30 patients had circumferential RAI (CRAI), and 50 had non-CRAI. There were no significant differences in age, parity, FI type, and FISI scores between the groups. However, FISI scores were significantly lower in 51 patients with passive FI than 12 patients with mixed FI type [21 (8–38) vs. 32 (8–43), P = 0.007]. Endo-anal ultrasound showed no significant difference in the incidence of sphincter defects between the groups. Maximum squeeze pressure was significantly lower in the erect position than in the left-lateral position in the CRAI patients [119 cm H2O (59‒454 cm H2O) vs. 145 cm H2O (65‒604 cm H2O), P = 0.006] however, this finding was not observed in the non-CRAI group and the subgroup of anterior RAI patients. In either group, maximum resting pressure, defecation desire volume, and maximum tolerated volume were significantly higher, while anal canal length was significantly shorter in the erect position than in the left-lateral position, respectively. Conclusion Voluntary contraction in female FI patients with CRAI was suppressed in the erect position.

show abstract

“…Hence, multiple factors lead to underestimating fecal problems. 4 Although a few studies have reported an association between the presence of constipation and/or FI and reduced quality of life (QoL), 3,[5][6][7] little is known about the association between the severity of constipation or FI and QoL. However, these studies show ambiguous outcomes and are restricted to patient populations.…”

Section: Principales Medidas De Resultadomentioning

confidence: 99%

“…However, these studies show ambiguous outcomes and are restricted to patient populations. 6,7 A few studies have documented fecal problems in the general population. Nevertheless, only a limited number of publications are dedicated to constipation, FI, and their coexistence in relation to QoL and its different domains of people struggling with such problems.…”

Section: Principales Medidas De Resultadomentioning

confidence: 99%

The Severity of Fecal Problems Is Negatively Associated With Quality of Life in a Dutch Population Without Bowel Function Comorbidities

ten Hoor,

Trzpis,

Broens

2023

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

BACKGROUND: Constipation and fecal incontinence have a negative influence on quality of life. The association between the severity of fecal problems and quality of life has not been investigated in a non-patient population. OBJECTIVE: To investigate the association between the severity of constipation and fecal incontinence and quality of life in non-patients. DESIGN: A population-based, cross-sectional study. SETTINGS: The study involved 3668 Dutch non-patients. PATIENTS: A survey company conducted a population-wide study of the general Dutch population. Altogether, 5000 Dutch citizens completed the Groningen Defecation and Fecal Continence and Short-Form 36 questionnaires. The data on 3668 respondents without comorbidities that could influence bowel function were included for analysis. MAIN OUTCOME MEASURES: The severity of constipation (Agachan score) and fecal incontinence (Wexner score) in relation to the quality-of-life scores. RESULTS: In the non-patient population (n = 3668), 487 (13.3%) had constipation, 116 (3.2%) had fecal incontinence, and the two fecal problems coexisted in 64 (1.7%). In the multivariable analysis, all quality-of-life domains were negatively associated with the severity of constipation and fecal incontinence. The associations between the severity of constipation and quality of life were stronger (highest: ß = -2.413, 95% CI, -2.681 to -2.145, p = < 0.001) than those of fecal incontinence (highest: ß = -1.280, 95% CI, -1.681 to -.880, p = < 0.001). We also found that a longer duration of bowel complaints coincided with higher severity scores, especially for constipation. Mostly, respondents rated their defecation health as positive, regardless of the severity of their fecal problems. LIMITATIONS: Cross-sectional design. CONCLUSIONS: The severity of constipation and fecal incontinence is significantly associated with reduced quality of life, with the severity of constipation having stronger associations than fecal incontinence. Given respondents' unawareness of their fecal problems and the progressive character thereof, timely intervention is advocated.

show abstract

Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects

Cited by 9 publications

References 25 publications

Sacral nerve stimulation for fecal incontinence

Sacral nerve stimulation for fecal incontinence

Effect of posture on anorectal manometric measurements in female patients with fecal incontinence and rectoanal intussusception

The Severity of Fecal Problems Is Negatively Associated With Quality of Life in a Dutch Population Without Bowel Function Comorbidities

Contact Info

Product

Resources

About