Evaluation and validation of the anal sphincter function by anal manometry

Introduction: Anal manometry is a very common method to evaluate anal sphin cter function. Despite that there are many doubts about reliability and rep roducibility. The aim of this study is to proof reliability of anal manomet ry in healthy controls and clinically incontinent patients. Method: We examined 15 controls (age: 24 (21 - 28) years; male, fully conti nent) and 10 incontinent patients (age: 51 (31-58) years; m:w = 4:6,Kelly-H ohlschneider-Score <4) at 3 different day-times (09:00, 13:00, 17:00), whic h was repeated after 2 weeks time. The examination was performed by an inde pendent examiner. The parameters were: Resting pressure (RP), Squeezing pre ssure (SP) [mmHg], radial asymmetry in rest (RARP) and squeezing (RASP) [%] and vektorvolume in rest (VVRP) and squeezing (VVSP) [cm(3)] rectal compli ance and max. tolerable volume (MTV). The statistical equality was stated b y Pearson's correlation-coefficient for the controls and Spearman's correla tion-coeffizient for incontinent patients (r = correlation-coefficient). Results: All parameters showed a statistically significant parity. Just res ting pressures were not reproducible in incontinents as well as compliance and radial asymmetry in controls. Discussion: 1. All parameters show a significant reproducibility concerning their circadian, longitudinal and intraindividual course. Only squeeze pre ssures for incontinent patients, radial asymmetry and compliance in control s show a lower reproducibility. 2. Vector-volume-manometry is an appropriat e method to diagnose incontinence and to survey biofeedback-training.