Three-Dimensional Anorectal Manometry Enhances Diagnostic Gain by Detecting Sphincter Defects and Puborectalis Pressure

Raja, Shreya; Okeke, Francis; Stein, Ellen M.; Dhalla, Sameer; Nandwani, Monica; Lynch, Kristle L.; Gyawali, C. Prakash; Clarke, John O.

doi:10.1007/s10620-017-4466-5

Cited by 18 publications

(17 citation statements)

References 14 publications

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“…The application of a three-dimensional probe to HRAM equipment as performed in our study has been compared to the use of a two-dimensional probe in a study by Raja et al in a retrospective study of 221 patients 18 . The 3D probe enhances diagnostic gains by the identification of 29 focal anal sphincter defects not identified by 2D examinations and had a fair inter-reader agreement.…”

Section: Discussionmentioning

confidence: 99%

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Bjørsum-Meyer

Christensen

Jakobsen

et al. 2020

Sci Rep

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Anorectal malformations (ARM) are a spectrum of anomalies of the rectum and anal canal affecting 1 in 2500 to 5000 live births. Functional problems are common and related to the type of ARM and associated malformations. We aimed to evaluate the results of Three-dimensional High Resolution Anorectal Manometry (3D-HRAM) in long-term follow-up after surgical correction of ARM with special reference to fecal incontinence. twenty-one patients with anorectal malformations and primary repair at our center consented to participate in the study. pressures of the anal sphincter muscles and defects were addressed by 3D-HRAM. Fecal incontinence and disease-specific quality of life were evaluated by the fecal incontinence Quality of Life score and Wexner incontinence score respectively. the study was approved by the Committee in Health Research Ethics and the Danish Data Protection Agency. Median age was 22(12-31) years and 13(67%) participants were females. Sphincter defect was present in 48% (n = 10) of participants. Participants with sphincter defects had significant higher Wexner score and size of sphincter defects and mean anal squeeze pressure were correlated to Wexner score. Participants with or without sphincter defects did not differ on manometry parameters including resting anal and squeeze pressure or disease-specific quality of life. In a study of the long-term outcome after repair of anorectal malformations we found a higher Wexner incontinence score in the presence of an anal sphincter defect and the size of the defect and mean anal squeeze pressure were correlated to the Wexner incontinence score.

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Section: Discussionmentioning

confidence: 99%

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Bjørsum-Meyer

Christensen

Jakobsen

et al. 2020

Sci Rep

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“…Así pues, esta técnica puede tener un papel en la evaluación de alteraciones anatómicas. En este sentido, se ha señalado la utilidad de la MAR-AD en el diagnóstico de defectos esfintéricos al compararse con la ecografía endoanal 54,55 . El grupo de Rao, et al 56 presentó un trabajo pionero al respecto, en el cual se evaluó a 10 pacientes con IF (ocho mujeres con edad promedio de 58 años), 10 con EC (nueve mujeres con edad promedio de 48 años) y 10 controles sanos (cuatro mujeres con edad promedio de 35 años) mediante MAR-AD y USG endoanal, con la finalidad evaluar las ventajas de esta novedosa técnica.…”

Section: Aspectos Clínicos Y Utilidad De La Mar-adunclassified

Manometría anorrectal: ¿alta resolución o alta definición? Pros y contras

Troche¹

2019

NGL

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Aspectos técnicos La manometría anorrectal (MAR) es una técnica que permite, mediante el registro simultáneo a diferentes niveles de los cambios de ABSTRACT Anorectal disorders can affect up to 15% of the population and are a consequence of neuromuscular alterations of the pelvic floor. The neurophysiological tests that evaluate the motor and sensory function of the anorectum provide very important information regarding the physiopathological mechanisms involved in anorectal disorders. Anorectal manometry (ARM) is considered the ideal test to evaluate the motor and sensory function of the anorectum. High resolution ARM (HR-ARM) and high definition (HD-ARM) are technologies that represent an evolution in the study of the physiology and anatomy of the structures involved in continence and evacuation. The objective of this review is to evaluate and compare HR-ARM, HD-ARM and conventional ARM in terms of its technological development, analysis and interpretation of these tests, as well as its usefulness in clinical practice. According to our review, HR-ARM and HD-ARM have greater recording capacity, are less variable, more reproducible, but also more expensive compared to conventional ARM. HD-ARM has the advantage of providing a reconstruction in 3 planes that could be compared with the endoanal ultrasound. It is important to mention that new parameters are being developed that will allow a better understanding of anorectal function, which probably leads to a reclassification of anorectal disorders. Up to now, HR-ARM and HD-ARM do not seem to have made a major diagnostic advance in routine clinical practice with respect to conventional ARM. This is an important issue to highlight since, in many parts of the world, the latter technology is the only one available and it is very useful.

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“…3F). Furthermore, these techniques may play a role in the assessment of anatomical changes; in this respect, HD-ARM has been shown to be useful for the diagnosis of sphincter disorders when compared to endoanal ultrasound (38,39). Similarly, HR-ARM and HD-ARM may be useful for the diagnosis of pelvic floor disorders including descending perineum syndrome (40,41), rectal prolapse and intussusception ( Fig.…”

Section: New Hr-arm and Hd-arm Parameters And Interpretationmentioning

confidence: 99%

High-resolution and high-definition anorectal manometry: rediscovering anorectal function

Ríos¹,

Mínguez²,

Remes-Troche³

et al. 2018

Rev Esp Enferm Dig

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assess anorectal function provides highly significant information on the pathophysiological mechanisms involved in the genesis of fecal incontinence, pelvic floor dyssynergia, rectal hypo-or hypersensitivity, and pelvic neuropathy (3). Anorectal manometry (ARM) is a technique that, by simultaneously recording intraluminal pressure changes at multiple levels, allows to assess anorectal motor activity both at rest and mimicking multiple physiological situations (rectoanal inhibitory reflex, retention effort, defecation maneuver, Valsalva reflex). While barostat represent the gold standard in the evaluation of rectal sensitivity, ARM may also assess it provided the device is fitted with a distensible rectal balloon. This technique, together with balloon expulsion testing, is used in standard clinical practice for the diagnosis of defecatory disorders in patients with constipation refractory to standard therapy with hygienic-dietary measures and laxatives (4), in the assessment of patients with fecal incontinence (5), to administer biofeedback therapy to patients with constipation and/or fecal incontinence, in the assessment of anorectal pain syndromes (proctalgia), and even for the preoperative and postoperative evaluation of ileorectal anastomoses (6). High-resolution anorectal manometry (HR-ARM) and high-definition anorectal manometry (HD-ARM), available since 2007, are increasingly used in clinical practice. In comparison to the conventional technique, HR-ARM and HD-ARM catheters provide a greater number of recording points thanks to their multiple, closely packed circumferential sensors. This allows time-space visualization (topograph

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Three-Dimensional Anorectal Manometry Enhances Diagnostic Gain by Detecting Sphincter Defects and Puborectalis Pressure

Abstract: PR function and focal defects can be visualized on 3D-HRAM with added diagnostic benefit compared to 2D. Fair inter-reader agreement for focal defects highlights the need for quantitative metrics.

Cited by 18 publications

References 14 publications

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Manometría anorrectal: ¿alta resolución o alta definición? Pros y contras

High-resolution and high-definition anorectal manometry: rediscovering anorectal function

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