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Anorectal Manometry

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Pelvic Floor Disorders

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Abstract

Anorectal manometry is considered a valuable test for diagnosis and management of fecal incontinence. It is used to identify functional sphincter weakness, poor rectal compliance, and rectal sensation impairment. Anal resting pressure may be reduced in fecal incontinence, and dysfunction of the internal anal sphincter may be suspected in these patients. Maximal voluntary contraction is frequently impaired in incontinent patients, and this sign is related to external anal sphincter dysfunction. A significant decrease or loss of rectal sensation may contribute to fecal incontinence by impairing the recognition of impending defecation, and substantial decreases in rectal compliance are associated with urge fecal incontinence. The rehabilitative treatment of fecal incontinence is guided by anorectal manometry, and the algorithm for the multimodal rehabilitation is based on manometric reports. Furthermore, anorectal manometry can help to select candidates for overlap** sphincteroplasty and identifies those patients with rectal prolapse who are at high risk for postoperative incontinence, modifying the surgical strategy of simple correction of prolapse. In conclusion, anorectal manometry offers decisive data for understanding the pathophysiology of fecal incontinence and can modify the therapeutic strategy.

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Author information

Authors and Affiliations

  1. Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy

    Filippo Pucciani

  2. Proctology Unit, USL Toscana Centro, Firenze, Italy

    Iacopo Giani

Authors
  1. Filippo Pucciani
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  2. Iacopo Giani
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Corresponding author

Correspondence to Filippo Pucciani .

Editor information

Editors and Affiliations

  1. Tertiary Referral Pelvic Floor and Incontinence Center, IV°Division of General Surgery, Regional Hospital, Treviso, University of Padua, Padua, Italy

    Giulio A. Santoro

  2. Department of Pediatric Radiology, Medical University of Lublin, Children’s University Hospital, Lublin, Poland

    Andrzej P. Wieczorek

  3. Urogynaecology and Pelvic Floor, Reconstruction Unit, Croydon University Hospital, St George’s University of London, London, UK

    Abdul H. Sultan

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Pucciani, F., Giani, I. (2021). Anorectal Manometry. In: Santoro, G.A., Wieczorek, A.P., Sultan, A.H. (eds) Pelvic Floor Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-40862-6_31

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  • DOI: https://doi.org/10.1007/978-3-030-40862-6_31

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40861-9

  • Online ISBN: 978-3-030-40862-6

  • eBook Packages: MedicineMedicine (R0)

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