ENDOANAL ULTRASOUND IN THE DIAGNOSTICS OF ANAL INCONTINENCE

Endoanal ultrasound is a new imaging technique in the diagnostic work- up of patients suffering from anal incontinence. A standardised examin ation as well as hardware specific reference values for the sphincter muscles are of paramount importance to allow correct interpretation of the continence organ. At the University Hospital of Wurzburg from 1.2 . 1993 to 31.7. 1994 90 patients (50 male, 40 female; age: 16-81 y.) w ith normal continence underwent endosonographic assessment of their sp hincter complex. We measured the internal anal sphincter (IAS), pubore ctalis muscle as well as the three separate parts of the external anal muscle (EAS). Apart from establishing reference values we found a sig nificant increase in thickness of both EAS and IAS with increasing age , However, no correlation was seen between muscle thickness, sex, heig ht or weight. We also examined 29 patients with a history of incontine nce. 13 (45%) had a morphological sphincter defect, most of which were due to obstetric trauma or previous proctological operations. 10 (35% ) patients suffered from so called idiopathic incontinence. Anal ultra sound in these patients revealed muscle hypotrophy of the structurally intact sphincters.