PURPOSE: This study was designed to investigate the reliability of thr
ee-dimensional vectormanometry for differential diagnosis of fecal inc
ontinence. METHODS: Eight-channel, continuous pull-out perfusion manom
etry was performed on 23 female patients with traumatic (n = 11) or id
iopathic (n = 12) incontinence, respectively. RESULTS: At rest, the mi
nimum sector pressure of patients with traumatic incontinence (32 +/-
14 mmHg) was significantly lower than it was in the controls (76 +/- 1
6 mmHg) and in those with idiopathic incontinence (64 +/- 28 mmHg) (P
< 0.001). At maximum squeezing, the minimum sector pressure was 57 +/-
22 mmHg in patients with traumatic incontinence and 79 +/- 33 mmHg in
those with idiopathic incontinence, both being significantly lower th
an in the control group with 152 +/- 27 mmHg (P < 0.001). The asymmetr
y index of the patients with a sphincter defect was significantly high
er, both at rest (23 +/- 13 percent) and squeeze (26 +/- 12 percent),
in comparison with the control group (7 +/- 2 percent at rest and 6.2
+/- 1.6 percent at squeeze) and the patients with idiopathic incontine
nce (10 +/- 5 percent at rest and 8.4 +/- 4 percent at squeeze). CONCL
USION: Three-dimensional vectormanometry identifies localized pressure
deficits in the anal canal, thereby differentiating between sectorial
and global sphincter insufficiency.