Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

Hornung, B. R.; Telford, Karen; Carlson, Gordon L; Mitchell, Peter; Klarskov, Niels; Kiff, E. S.

doi:10.1097/dcr.0000000000000790

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…Few reports to date, however, have assessed the functional cooperation between the IAS and EAS, as the two sphincters were usually examined separately. Another reason of few interests in the distal IAS-EAS complex was found in a fact that, with an aid of the levator ani muscle, a closing pressure is highest in the proximal anal canal, not in the distal [5,10,33].…”

Section: Discussionmentioning

confidence: 99%

“…However, recently, another term "longitudinal anal muscle" has been used in the pelvic floor anatomy [16,21,28,30]. Despite recent advances in imaging technology [5,10,22,33], few studies have evaluated site-dependent differences in the topographical relationship between the internal and external anal sphincters (IAS, EAS). Endoanal ultrasound evaluation of 12 men and 14 women showed that: (1) the anterior IAS is shorter than the posterior and lateral IAS; and (2) the distance from the lateral EAS to the pubis is significantly longer than the distance from the posterior EAS to the pubis [29].…”

Section: Introductionmentioning

confidence: 99%

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A missing distal complex of the external and internal anal sphincters: a macroscopic and histologic study using Japanese and German elderly cadavers

Ishiyama¹,

Kim

Chai

et al. 2020

Surg Radiol Anat

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The lower margin of the internal anal sphincter (IAS) is considered to lie on a J-shaped, subcutaneous part (SCP) of the external anal sphincter (EAS). The lower IAS is united with the J-shaped SCP to form a smooth-striated muscle complex. In the first part of this study, we ensured the presence of the J-shaped EAS in the lateral wall of the anal canal from 12 near-term fetuses. Second, in the lateral anal wall, the examination of the longitudinal section from 20 male and 24 female Japanese cadavers (72-95 years-old) demonstrated that the J-shaped EAS was lost in 15 (34%) due to the very small SCP. Third, we demonstrated that the J-shaped EAS was restricted in the latera anal wall using longitudinal histological sections of the anal canal from 11 male Japanese cadavers (75-89 years-old). Therefore, a site-dependent difference in the IAS-EAS configuration was evident. Finally, we compared a frequency of the lost J-shape between human populations using 10 mm-thick frontal slices from 36 Japanese and 28 German cadavers. The two groups of cadavers were compatible in age (a 0.2-years' difference in males). The macroscopic observations revealed that the J-shaped EAS was absent from 13 (36%) Japanese and six (20%) German specimens, suggesting that the SCP degeneration occurred more frequent in elderly Japanese than elderly German individuals (p < 0.05). The distal IAS-EAS complex seemed to push residual feces out of the anal canal at a transient phase from evacuation to closure. The absence might be the first sigh of anal dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A missing distal complex of the external and internal anal sphincters: a macroscopic and histologic study using Japanese and German elderly cadavers

Ishiyama¹,

Kim

Chai

et al. 2020

Surg Radiol Anat

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“… Investigate newer technologies for measuring anal sphincter functions . By distending the anal sphincter, anal acoustic reflectometry and the anal barostat can assess the integrity and distensibility of the anal sphincter barrier 93–97 . A fecobionic silicon bag that resembles the consistency of normal stool has pressure and motion sensors that record pressures, anorectal angles, and expulsion velocity during defecation 98,99 …”

Section: Methodsmentioning

confidence: 99%

“…of the anal sphincter barrier. [93][94][95][96][97] A fecobionic silicon bag that resembles the consistency of normal stool has pressure and motion sensors that record pressures, anorectal angles, and expulsion velocity during defecation. 98,99 The incremental utility of these devices for understanding the pathogenesis or guiding the management of FI or DD remains to be established.…”

Section: Pressure Measurement In the Posterior Distal Pressure Zonementioning

confidence: 99%

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

Bharucha

Basilisco

Malcolm

et al. 2022

Neurogastroenterology Motil

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Anorectal manometry (ARM) is a sophisticated technique that quantifies several aspects of the complex and multifactorial mechanisms that regulate defecation and continence. 1 ARM records contractility and tone of the internal (IAS) and external anal sphincters (EAS); rectal sensitivity and compliance; the reflex relaxation of the IAS in response to rectal distension; the reflex contraction of the EAS in response to cough or Valsalva maneuver; and the dynamic changes of rectal and anal pressures during simulated evacuation. The technological advances of ARM and other techniques that assess colonic and anorectal functions (e.g., high-resolution colonic manometry and magnetic resonance imaging [MRI] proctography) have enhanced our understanding of the physiology of defecation and continence and related disorders. Anorectal manometry and the rectal balloon expulsion test are recommended initial tests for diagnosing DD in patients who have

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Effect of Single-Dose Imipramine on Anal Sphincter Tone in Healthy Women: A Randomized, Placebo-Controlled Study Using Anal Acoustic Reflectometry

Christoffersen,

Kornholt,

Riis

et al. 2024

Int Urogynecol J

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Introduction and Hypothesis Despite the high prevalence of fecal incontinence, existing treatment options may be inadequate. Drugs that enhance the tone of the anal sphincter complex could potentially be an effective pharmacological approach. This study investigated the effect of the tricyclic antidepressant imipramine on anal sphincter tone in healthy women, employing anal acoustic reflectometry as the evaluating method. Methods In a double-blind, randomized, placebo-controlled crossover study, 16 healthy female volunteers were randomized to one of two treatment sequences. The participants attended two study visits separated by at least 7 days’ washout. At each visit, they received a single dose of 50 mg imipramine or matching placebo, in alternating order. We assessed the anal opening pressure under the resting state and during voluntary squeezing of the pelvic floor. Measurements were performed pre-dose and 1 h after drug administration, corresponding to the estimated time of peak plasma concentration of imipramine. Results All participants completed the study. In total, 44% of the participants reported at least one adverse effect, primarily anticholinergic. Compared with placebo, imipramine increased anal opening pressure by 15.2 cmH2O (95% confidence interval [CI] 2.0–28.2 cmH2O, p = 0.03) in the resting state and 15.1 (95% CI 4.2–26.0 cmH2O, p = 0.01) cmH2O during squeezing. Conclusions The findings indicate that imipramine increases anal sphincter tone in healthy women. However, further research is required to evaluate its clinical impact on individuals with fecal incontinence. This research also demonstrates the effectiveness of using anal acoustic reflectometry for assessing pharmacological effects on anal sphincter function.

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Use of Anal Acoustic Reflectometry in the Evaluation of Men With Passive Fecal Leakage

Cited by 4 publications

References 20 publications

A missing distal complex of the external and internal anal sphincters: a macroscopic and histologic study using Japanese and German elderly cadavers

A missing distal complex of the external and internal anal sphincters: a macroscopic and histologic study using Japanese and German elderly cadavers

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

Effect of Single-Dose Imipramine on Anal Sphincter Tone in Healthy Women: A Randomized, Placebo-Controlled Study Using Anal Acoustic Reflectometry

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