Degirmenci Yaman, Steetskamp Joscha, Schwab Roxana, Hasenburg Annette, Schepers Markus, Shehaj Ina, Skala Christine
Department of Gynecology and Obstetrics, University Medical Center of Johannes Gutenberg University, 55131 Mainz, Germany.
Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of Johannes Gutenberg University, 55131 Mainz, Germany.
Diagnostics (Basel). 2024 Nov 21;14(23):2614. doi: 10.3390/diagnostics14232614.
BACKGROUND/OBJECTIVES: Anal incontinence is linked to pelvic floor dysfunction. Diagnosis involves assessing both the function and structure of the anorectal unit. Although transperineal ultrasound has gained attention as a less invasive option, its effectiveness as a diagnostic tool for evaluating the relationship between structure and function is still debated. This study aimed to explore the relationship between quantitative measurements of anal sphincter and pelvic floor structures as well as the subjective symptoms and objective assessments of sphincter function regarding anal incontinence.
50 women with pelvic floor dysfunction were recruited for the study. The severity of anal incontinence was assessed using the CACP score. Ultrasound imaging was employed to measure anal sphincter area, while sphincter pressures were evaluated through manometry. The relationships between variables were analyzed using Pearson's and Spearman's correlation tests.
The mean anal sphincter area was 5.51 cm at rest and 4.06 cm during maximal contraction. Resting anal sphincter pressure had an average of 46.29 mmHg, and contraction pressure averaged 103.25 mmHg. No significant correlation was found between the anal sphincter area and pressure at rest (r = 0.018) or during contraction (r = -0.210). However, a moderate correlation was observed between the change in sphincter pressure and area during contraction (r = 0.312). The CACP score showed no significant correlation with the sphincter area at rest (r = -0.084) but was weakly correlated during contraction (r = -0.270).
Conventional diagnostic tools for evaluating anal incontinence can be uncomfortable and are not always readily available. Perineal sonography presents a promising, less invasive alternative for dynamic assessment of the anal sphincter.
背景/目的：肛门失禁与盆底功能障碍相关。诊断需要评估肛门直肠单元的功能和结构。尽管经会阴超声作为一种侵入性较小的选择已受到关注，但其作为评估结构与功能关系的诊断工具的有效性仍存在争议。本研究旨在探讨肛门括约肌和盆底结构的定量测量之间的关系，以及肛门失禁的主观症状和括约肌功能的客观评估之间的关系。
招募50名盆底功能障碍的女性参与本研究。使用CACP评分评估肛门失禁的严重程度。采用超声成像测量肛门括约肌面积，同时通过测压评估括约肌压力。使用Pearson和Spearman相关检验分析变量之间的关系。
静息时肛门括约肌平均面积为5.51平方厘米，最大收缩时为4.06平方厘米。静息时肛门括约肌压力平均为46.29毫米汞柱，收缩压力平均为103.25毫米汞柱。未发现肛门括约肌面积与静息时压力（r = 0.018）或收缩时压力（r = -0.210）之间存在显著相关性。然而，观察到收缩时括约肌压力变化与面积之间存在中度相关性（r = 0.312）。CACP评分与静息时括约肌面积无显著相关性（r = -0.084），但在收缩时呈弱相关性（r = -0.270）。
用于评估肛门失禁的传统诊断工具可能会带来不适，且并非总是容易获得。会阴超声检查为肛门括约肌的动态评估提供了一种有前景的、侵入性较小的替代方法。
