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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 4/2019

01-04-2019 | Constipation | Original Article

Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study

Authors: Charlotte Andrianjafy, Laure Luciano, Camille Bazin, Karine Baumstarck, Michel Bouvier, Véronique Vitton

Published in: International Journal of Colorectal Disease | Issue 4/2019

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Abstract

Background

The aim of the study was to describe the results of 3D high-resolution anorectal manometry (3DHRAM) in a large cohort of patients with functional anorectal disorders.

Methods

In this single-center retrospective study, all consecutive patients referred for investigation of fecal incontinence (FI) or dyssynergic defecation (DD) underwent 3DHRAM. The parameters analyzed were usual manometric data, repartition of dyssynergic patterns, and the prevalence of a new “muscular subtype classification” underlying dyssynergia, anal sphincter defects, and pelvic floor disorders.

Results

Final analyses were performed in 1477 patients with a mean age 54 ± 16 years; 825 patients suffered from DD, and 652 patients suffered from FI. Among these patients, 86% met the diagnostic criteria for dyssynergia. Type II dyssynergia was the most frequently observed (56%) in women and men suffering from FI and in women with DD. Type I was the most frequently observed in men with DD (49%). Regarding the muscle type subgroups, combined puborectalis muscle involvement with an external anal sphincter profile was the most frequently observed. The global prevalence of rectal intussusception and excessive perineal descent were 12% and 21%, respectively. Type III dyssynergia was more frequently associated with pelvic floor disorders than were other types of dyssynergia (p < 0.001).

Conclusion

This large cohort study provides reference values for 3DHRAM in patients with functional anorectal disorders. Further studies are necessary to assess the prevalence of pelvic floor disorders in healthy volunteers and to develop new scores and classifications including all of these new parameters.
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Metadata
Title
Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study
Authors
Charlotte Andrianjafy
Laure Luciano
Camille Bazin
Karine Baumstarck
Michel Bouvier
Véronique Vitton
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 4/2019
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-019-03235-z

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