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Repeatability of anorectal manometry in healthy volunteers and patients

  • Author Footnotes
    1 These two authors contributed equally to this article.
    Susanne D. Otto
    Correspondence
    Corresponding author. Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin D-12203, Germany. Tel.: +49 30 8445-2543; fax: + 49 30 8445-2740.
    Footnotes
    1 These two authors contributed equally to this article.
    Affiliations
    Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Berlin, Germany
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  • Author Footnotes
    1 These two authors contributed equally to this article.
    Johanna M. Clewing
    Footnotes
    1 These two authors contributed equally to this article.
    Affiliations
    Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Berlin, Germany
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  • Jörn Gröne
    Affiliations
    Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Berlin, Germany
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  • Heinz J. Buhr
    Affiliations
    Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Berlin, Germany
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  • Anton J. Kroesen
    Affiliations
    Department of General, Vascular, and Thoracic Surgery, Charité – University Medicine Berlin, Berlin, Germany
    Search for articles by this author
  • Author Footnotes
    1 These two authors contributed equally to this article.

      Abstract

      Background

      Anorectal manometry is used extensively in the assessment of patients with disorders of the pelvic floor. The present study investigated the repeatability of anorectal manometry in healthy volunteers and patients.

      Patients and methods

      A total of 30 healthy volunteers (15 men and 15 women) and 10 patients with fecal incontinence (4 men and 6 women) underwent perfusion manometry and volumetry. Intraindividual variability was evaluated using the intraindividual correlation coefficient (ICC). Interindividual variability was expressed as the standard deviation from the calculated mean values.

      Results

      We found a high intraindividual correlation for the squeezing pressure (ICC 0.75–0.95), vector volume (ICC 0.88–0.97), and rectal perception (ICC 0.82–0.98). The anal resting pressure showed moderate repeatability (ICC 0.60–0.72). However, with regard to sphincter asymmetry, rectal compliance, and the rectoanal inhibitory reflex, a wide range of variability was found. In the female volunteers, the squeezing pressure and vector volume were lower than in those in the male volunteers. The anal pressure, vector volume, thresholds for urgency, and the maximum tolerable volume were lower in the incontinent patients than in the healthy volunteers.

      Conclusions

      The squeezing pressure, vector volume, and rectal perception allow a reliable analysis of anal sphincter function. Sphincter asymmetry, rectal compliance, and the rectoanal inhibitory reflex were of limited diagnostic value.

      Keywords

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