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External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects continence after sphincteroplasty

External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects... BackgroundThere is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging (MRI). The aims of this study were to investigate the prevalence of external anal sphincter atrophy in women with anterior sphincter defects due to obstetric injury and to determine the impact of external anal sphincter atrophy on the outcome of sphincteroplasty.MethodsIn this prospective study, 20 consecutive women (median age 50 (range 28–75) years) with faecal incontinence due to obstetric trauma were assessed before operation with endoanal ultrasonography and endoanal MRI. The external anal sphincter was examined and evaluated for the presence of atrophy. The clinical outcome of sphincteroplasty was interpreted without knowledge of the magnetic resonance and ultrasonographic images.ResultsIn all patients anterior sphincter defects could be demonstrated with ultrasonography and MRI. External anal sphincter atrophy could only be demonstrated on MRI. Eight of 20 patients had external anal sphincter atrophy. Continence was restored in 13 patients. Outcome was significantly better in those without external anal sphincter atrophy (11 of 12 patients versus two of eight; P = 0·004).ConclusionExternal anal sphincter atrophy can only be visualized on endoanal MRI and affects continence after sphincteroplasty. Endoanal MRI is valuable in the preoperative assessment of patients with faecal incontinence. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png British Journal of Surgery Oxford University Press

External anal sphincter atrophy on endoanal magnetic resonance imaging adversely affects continence after sphincteroplasty

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References (34)

Publisher
Oxford University Press
Copyright
© 1999 British Journal of Surgery Society Ltd
ISSN
0007-1323
eISSN
1365-2168
DOI
10.1046/j.1365-2168.1999.01244.x
Publisher site
See Article on Publisher Site

Abstract

BackgroundThere is still considerable debate about the value of preoperative anorectal physiological parameters in predicting the clinical outcome after sphincteroplasty. Recently it has been reported that atrophy of the external anal sphincter can be clearly shown with endoanal magnetic resonance imaging (MRI). The aims of this study were to investigate the prevalence of external anal sphincter atrophy in women with anterior sphincter defects due to obstetric injury and to determine the impact of external anal sphincter atrophy on the outcome of sphincteroplasty.MethodsIn this prospective study, 20 consecutive women (median age 50 (range 28–75) years) with faecal incontinence due to obstetric trauma were assessed before operation with endoanal ultrasonography and endoanal MRI. The external anal sphincter was examined and evaluated for the presence of atrophy. The clinical outcome of sphincteroplasty was interpreted without knowledge of the magnetic resonance and ultrasonographic images.ResultsIn all patients anterior sphincter defects could be demonstrated with ultrasonography and MRI. External anal sphincter atrophy could only be demonstrated on MRI. Eight of 20 patients had external anal sphincter atrophy. Continence was restored in 13 patients. Outcome was significantly better in those without external anal sphincter atrophy (11 of 12 patients versus two of eight; P = 0·004).ConclusionExternal anal sphincter atrophy can only be visualized on endoanal MRI and affects continence after sphincteroplasty. Endoanal MRI is valuable in the preoperative assessment of patients with faecal incontinence.

Journal

British Journal of Surgery – Oxford University Press

Published: Oct 1, 1999

Keywords: magnetic resonance imaging; atrophy; sphincteroplasty; external anal sphincter; sphincter; treatment outcome; ultrasonography; fecal incontinence; preoperative care; obstetrics; preoperative medical evaluation; endoanal ultrasound examination; nuclear magnetic resonance; traumatic lesion during delivery

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