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Endosonography of the anal sphincter in women of different ages and parity.

Starck-Söndergaard, Marianne LU ; Bohe, Måns LU ; Fortling, B and Valentin, Lil LU (2005) In Ultrasound in Obstetrics & Gynecology 25(2). p.169-176
Abstract
Objectives

To obtain reference data representative of normal findings at anal endosonography in pregnant and non-pregnant women. To determine intraobserver and interobserver agreement in the detection of endosonographic anal sphincter defects in asymptomatic women.



Methods

Twenty-five non-pregnant nulliparous women and 25 non-pregnant parous women (age range, 20-67 years) and 47 pregnant women (age range, 21-39 years) underwent anal manometry and anal endosonography. The endosonographic internal and external sphincter thickness and sphincter length were measured online. Endosonographic sphincter defects were measured and classified offline from videotapes by two independent examiners using an... (More)
Objectives

To obtain reference data representative of normal findings at anal endosonography in pregnant and non-pregnant women. To determine intraobserver and interobserver agreement in the detection of endosonographic anal sphincter defects in asymptomatic women.



Methods

Twenty-five non-pregnant nulliparous women and 25 non-pregnant parous women (age range, 20-67 years) and 47 pregnant women (age range, 21-39 years) underwent anal manometry and anal endosonography. The endosonographic internal and external sphincter thickness and sphincter length were measured online. Endosonographic sphincter defects were measured and classified offline from videotapes by two independent examiners using an endosonographic defect score ranging from 0 (no defect) to 16 (maximal defect), the score taking into account the location and the longitudinal and circumferential extension of the defect.



Results

Endosonographic sphincter thickness and length did not differ between non-pregnant nulliparous and parous women and did not change substantially with age. The anal sphincter was thicker and the anal resting pressure area and manometric sphincter length were greater in pregnant than in non-pregnant women of the same age (20-39 years). There was good intra- and interobserver agreement with regard to detection of endosonographic anal sphincter defects (kappa 0.70). Eighteen (19%) women had endosonographic sphincter defects but in only four (4%; 4/97) cases were they moderate or large (defect score, 7-10). Ten (20%) of the non-pregnant women reported minor gas incontinence and one reported minor incontinence for both gas and liquid stool. The frequency of incontinence did not differ between women with and without sphincter defects.



Conclusions

Reference data representative of normal findings at anal endosonography have been established for non-pregnant women and for nulliparous women in the third trimester of pregnancy. Small endosonographic sphincter defects and minor gas incontinence are common in women without known sphincter trauma. They seem to be unrelated to each other and may be regarded as normal variants. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
female anal sphincter, anal manometry, endosonography, normal anatomy
in
Ultrasound in Obstetrics & Gynecology
volume
25
issue
2
pages
169 - 176
publisher
John Wiley & Sons
external identifiers
  • pmid:15685668
  • wos:000227027400012
  • scopus:14544274118
ISSN
1469-0705
DOI
10.1002/uog.1818
language
English
LU publication?
yes
id
74af6054-3707-42c2-bd39-717b1789fcc2 (old id 133947)
date added to LUP
2007-07-30 16:08:47
date last changed
2017-07-02 04:23:50
@article{74af6054-3707-42c2-bd39-717b1789fcc2,
  abstract     = {Objectives<br/><br>
To obtain reference data representative of normal findings at anal endosonography in pregnant and non-pregnant women. To determine intraobserver and interobserver agreement in the detection of endosonographic anal sphincter defects in asymptomatic women.<br/><br>
<br/><br>
Methods<br/><br>
Twenty-five non-pregnant nulliparous women and 25 non-pregnant parous women (age range, 20-67 years) and 47 pregnant women (age range, 21-39 years) underwent anal manometry and anal endosonography. The endosonographic internal and external sphincter thickness and sphincter length were measured online. Endosonographic sphincter defects were measured and classified offline from videotapes by two independent examiners using an endosonographic defect score ranging from 0 (no defect) to 16 (maximal defect), the score taking into account the location and the longitudinal and circumferential extension of the defect.<br/><br>
<br/><br>
Results<br/><br>
Endosonographic sphincter thickness and length did not differ between non-pregnant nulliparous and parous women and did not change substantially with age. The anal sphincter was thicker and the anal resting pressure area and manometric sphincter length were greater in pregnant than in non-pregnant women of the same age (20-39 years). There was good intra- and interobserver agreement with regard to detection of endosonographic anal sphincter defects (kappa 0.70). Eighteen (19%) women had endosonographic sphincter defects but in only four (4%; 4/97) cases were they moderate or large (defect score, 7-10). Ten (20%) of the non-pregnant women reported minor gas incontinence and one reported minor incontinence for both gas and liquid stool. The frequency of incontinence did not differ between women with and without sphincter defects.<br/><br>
<br/><br>
Conclusions<br/><br>
Reference data representative of normal findings at anal endosonography have been established for non-pregnant women and for nulliparous women in the third trimester of pregnancy. Small endosonographic sphincter defects and minor gas incontinence are common in women without known sphincter trauma. They seem to be unrelated to each other and may be regarded as normal variants.},
  author       = {Starck-Söndergaard, Marianne and Bohe, Måns and Fortling, B and Valentin, Lil},
  issn         = {1469-0705},
  keyword      = {female anal sphincter,anal manometry,endosonography,normal anatomy},
  language     = {eng},
  number       = {2},
  pages        = {169--176},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Endosonography of the anal sphincter in women of different ages and parity.},
  url          = {http://dx.doi.org/10.1002/uog.1818},
  volume       = {25},
  year         = {2005},
}