NEW CHALLENGE FOR ENDORECTAL SONOGRAPHY - DIAGNOSIS OF FECAL INCONTINENCE

The puborectalis muscle is a major determinant in the control of fecal continence. With endorectal sonography puborectalis function was asse ssed by determining puborectalis length in the resting (D1) and contra cted (D2) states and calculating the percentage of shortening (D1 - D2 /D1)(100). The puborectalis length was defined as the shortest distanc e between the symphysis pubis and the rectal mucosa. The mean puborect alis length at rest did not differ in control subjects (29.5 +/- 1.0 m m) and incontinent patients (29.0 +/- 2.9 mm). With voluntary contract ion a statistically significant difference (P < 0.001) was seen in the percentage of shortening between control subjects (15.4 +/- 1.1%) and incontinent patients (4.7 +/- 2.8%). Endorectal ultrasonography is a useful method to diagnose fecal incontinence.