Anal vector volume analysis: an effective tool in the management of pelvic floor disorders

Grande, Michele; Cadeddu, Federica; Sileri, Pierpaolo; Ciano, Paolo; Attinà, Grazia Maria; Selvaggio, I; Milito, G

doi:10.1007/s10151-010-0658-0

Cited by 7 publications

(12 citation statements)

References 22 publications

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“…Vector manometry provides information about circumferential differences in the anal canal, but the method does not provide information about tissue resistance to distension. 26 Another limitation is the 5 mm spacing between the electrode pairs on the FLIP which makes exact calculation of anal canal length impossible. Because of this, and to reduce the risk of results being affected by a potential change in anal length during distension, we choose our main points for data analysis to be the middle anal canal and the two points located 75% of the length toward its proximal and distal limits.…”

Section: Discussionmentioning

confidence: 99%

Distensibility of the anal canal in patients with idiopathic fecal incontinence: a study with the Functional Lumen Imaging Probe

Sørensen

Liao

Lundby

et al. 2013

Neurogastroenterology Motil

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Section: Discussionmentioning

confidence: 99%

Distensibility of the anal canal in patients with idiopathic fecal incontinence: a study with the Functional Lumen Imaging Probe

Sørensen

Liao

Lundby

et al. 2013

Neurogastroenterology Motil

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“…This will probably restrict the usefulness of FLIP in patients with lesions localized to part of the circumference including patients with traumatic or obstetric sphincter lesions. Pressure measurements as obtained with vector manometry do not have this limitation [18]. The spacing of the electrode pairs (5 mm) limits the spatial resolution of the FLIP.…”

Section: Discussionmentioning

confidence: 99%

Functional luminal imaging probe: a new technique for dynamic evaluation of mechanical properties of the anal canal

et al. 2012

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BackgroundThe muscle structures surrounding the anal canal are of major importance in maintaining continence but their anatomy and function vary along its length. Standard manometry does not provide detailed information about mechanical properties of the anal canal. A new functional luminal imaging probe (FLIP) has been developed for this purpose. The aim of our study was to investigate whether FLIP allows detailed evaluation of dynamic biomechanical properties along the length of the anal canal.MethodsThe in vitro validity and reproducibility of the FLIP system were tested. Fifteen healthy volunteers (age 32–65 years, mean 51 years), of whom 12 were females, were investigated. The integrity and dimensions of the anal sphincter apparatus were evaluated with endoanal ultrasonography and standard anal manometry. During standardized distensions with the FLIP, 16 cross-sectional areas of the anal canal were measured at 5-mm intervals. Distensibility of the following three segments was evaluated: upper anal canal (surrounded by the internal anal sphincter and the puborectalis muscle), mid-anal canal (surrounded by the internal anal sphincter and the external anal sphincter) and lower anal canal (surrounded by the external anal sphincter). Color contour plots were generated from the FLIP-based dynamic recordings of serial cross-sections.ResultsIn vitro tests confirmed the validity and reproducibility of the FLIP system. The luminal geometry during distension and the biomechanical properties of the anal canal differed at the three levels. Both at rest and during squeeze the mid-anal canal was significantly less distensible than the upper (p < 0.01) and the lower (p < 0.05) anal canal.ConclusionsFLIP is a promising method for evaluation of the nonhomogeneous biomechanical properties along the length of the anal canal.

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“…61,83,122,125,141,142, 146,170,183,199,200,227,251,253,258,261,264,285,296,298,302,353 Endoanal ultrasonography was performed in 104 studies (34.0%). 53,65,72,73,76–78,80,83,86,90,92,104,105,109,110,113, 115,122,125,127,133,141,142,146,151–153,155,157,162,163,165,167,172–176,178,179,183,191,193,…”

Section: Resultsmentioning

confidence: 99%

“…After careful evaluation of full‐text papers 27 studies were excluded: 15 studies 23–37 did not evaluate FI assessment, six manuscripts 38–43 were just protocols, five were paediatric studies, 44–48 and one trial 49 had an inappropriate study design. Finally, 328 studies were included in our review: 306 studies…”

Section: Resultsmentioning

confidence: 99%

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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Anal vector volume analysis: an effective tool in the management of pelvic floor disorders

Cited by 7 publications

References 22 publications

Distensibility of the anal canal in patients with idiopathic fecal incontinence: a study with the Functional Lumen Imaging Probe

Distensibility of the anal canal in patients with idiopathic fecal incontinence: a study with the Functional Lumen Imaging Probe

Functional luminal imaging probe: a new technique for dynamic evaluation of mechanical properties of the anal canal

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

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