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

Wickramasinghe, Dakshitha; Senaratne, Supun; Senanayake, Hemantha; Samarasekera, Dharmabandhu Nandadeva

doi:10.1002/jum.14640

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…10,13,17 That may explain why the reported mean length of the anal canal in nullipara differed from 3.3 to 4.2 cm and the anterior EAS length from 1.4 to 1.8 cm between the studies. 10,17 In a recent study by Wickramasinghe et al 18 including 101 primigravid Asian women in the early third trimester, normal material was established for sphincter thickness but not for sphincter length. In a study by Murad-Regadas et al 19 using a similar US endoanal transducer as in this study, the mean anterior EAS length was 1.8 cm in 35 nulliparous women.…”

Section: Discussionmentioning

confidence: 99%

Anal Sphincter Length as Determined by 3‐Dimensional Endoanal Ultrasound and Anal Manometry

Norderval

Pedersen

Collinson

2020

J of Ultrasound Medicine

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Objectives The normal female external anal sphincter (EAS) is shorter anteriorly than laterally and posteriorly. Furthermore, the thickness of the very proximal part of the circular EAS is thinner than 50% of the lateral and posterior EAS thickness. The extent of these features is not fully explored. The aim of this prospective study was to assess the normal anal sphincter with 3‐dimensional (3D) endoanal ultrasound (EAUS) and to relate 3D EAUS length measurements to sphincter length determined by anal manometry. Methods Healthy premenopausal nulliparous women underwent anal manometry and 3D EAUS examinations. Two experienced colorectal surgeons independently assessed all scans, blinded to any patient data. Results A total of 43 women were included. Four scans were incomplete and excluded from the analysis. Interobserver agreement was fair to very good for the various length measurements. The mean length from the distal border of the puborectal muscle to the very proximal border of the anterior EAS (the anterior gap) was 4.4 (95% confidence interval, 3.9–4.9) mm, whereas the length to the level where the anterior EAS thickness was at least 50% of the lateral and posterior EAS thickness was 7.2 (95% confidence interval, 6.5–7.9) mm. Manometric sphincter length at rest did not correlate with any 3D EAUS length measurements. Conclusions In the normal anterior female anal canal, the EAS is not present or appears with less than 50% of the thickness of the lateral and posterior EAS for the first 7.2 mm below the distal border of the puborectal muscle.

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Section: Discussionmentioning

confidence: 99%

Anal Sphincter Length as Determined by 3‐Dimensional Endoanal Ultrasound and Anal Manometry

Norderval

Pedersen

Collinson

2020

J of Ultrasound Medicine

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“…There is limited data available on the clinical usefulness and accuracy of 3D-EAUS done in South Asia [9]. Furthermore, the anatomy of the anal sphincters in South Asians are somewhat variable compared to other Asian and Western populations [9]. A study in South Asian females has found that the mean thicknesses of both the internal and external anal sphincters were less than other Asian women.…”

Section: Introductionmentioning

confidence: 99%

“…A study in South Asian females has found that the mean thicknesses of both the internal and external anal sphincters were less than other Asian women. The internal anal sphincter at the mid-sphincter level and the external anal sphincter at the lower sphincter level were thicker posteriorly, while the external anal sphincter at the mid-sphincter level was thicker anteriorly [9]. Therefore an attempt was made to analyse the effectiveness of 3D-EAUS in a cohort of the South Asian population.…”

Section: Introductionmentioning

confidence: 99%

Value of three-dimensional endoanal ultrasound scan (3D-EAUS) in preoperative assessment of fistula-in-ano

et al. 2019

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ObjectiveThe aim of this study was to determine the accuracy of three-dimensional endoanal ultrasound scan (3D-EAUS) in the pre-operative assessment of fistula-in-ano in identifying the fistula tract and comparing with findings at surgery in a South Asian cohort. A retrospective analysis of 87 patients with suspected fistula-in-ano who underwent pre-operative 3D-EAUS between January 2009 and January 2016 was carried out. All patients subsequently had surgical exploration under anaesthesia (EUA), irrespective of 3D-EAUS findings. The 3D-EAUS results were compared with the surgical findings to determine the accuracy of 3D-EAUS.ResultsA total of 86 (98.9%) patients (male = 75) were subsequently shown to have a fistula at surgical exploration and of them, 3D-EAUS detected a fistula in 79 (92%) patients. In this cohort, 3D-EAUS correctly predicted the surgical findings in (n = 61, 70.9%) patients with the highest accuracy being for transphincteric fistulae (87.1%). However, the overall concordance in our study was low with a kappa coefficient of 0.318. Additional findings such as sphincter defects were detected by the 3D-EAUS in 37 patients (internal sphincter defects-21, external sphincter defects-7, both-9) which were not evident at EUA. Therefore, 3D-EAUS had a good accuracy in selected types of fistulae and particularly useful in identifying sphincter defects before surgery.Electronic supplementary materialThe online version of this article (10.1186/s13104-019-4098-2) contains supplementary material, which is available to authorized users.

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Diagnostic Accuracy of Three-Dimensional Endoanal Ultrasound for Anal Fistula: A Systematic Review and Meta-analysis

Li¹,

Chen²,

Lin³

et al. 2021

Turk J Gastroenterol

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

Abstract: Normal values of 3DEAUS for primigravidae have been identified and may serve as reference values for other laboratories.

Cited by 3 publications

References 31 publications

Anal Sphincter Length as Determined by 3‐Dimensional Endoanal Ultrasound and Anal Manometry

Anal Sphincter Length as Determined by 3‐Dimensional Endoanal Ultrasound and Anal Manometry

Value of three-dimensional endoanal ultrasound scan (3D-EAUS) in preoperative assessment of fistula-in-ano

Diagnostic Accuracy of Three-Dimensional Endoanal Ultrasound for Anal Fistula: A Systematic Review and Meta-analysis

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