Three-dimensional High-resolution Anorectal Manometry in Children With Non-retentive Fecal Incontinence
- Author:
Marcin BANASIUK
1
;
Marcin DZIEKIEWICZ
;
Magdalena DOBROWOLSKA
;
Barbara SKOWROŃSKA
;
Łukasz DEMBIŃSKI
;
Aleksandra BANASZKIEWICZ
Author Information
- Publication Type:Original Article
- From:Journal of Neurogastroenterology and Motility 2022;28(2):303-311
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:Three-dimensional high-resolution anorectal manometry (3D-HRAM) is a precise tool to assess the function of the anorectum. Our aim is to evaluate children diagnosed with non-retentive fecal incontinence (NRFI) using 3D-HRAM.
Methods:In all children diagnosed with NRFI, manometric parameters and 3-dimensional reconstructions of the anal canal subdivided into 8 segments were recorded. All data were compared to raw data that were obtained from asymptomatic children, collected in ourlaboratory and published previously (C group).
Results:Forty children (31 male; median age, 8 years; range, 5-17) were prospectively included in the study. Comparison of the NRFI group and C group revealed lower values of mean resting pressure (74.4 mmHg vs 89.2 mmHg, P < 0.001) and maximum squeeze pressure (182 mmHg vs 208.5 mmHg, P = 0.018) in the NRFI group. In the NRFI group, the thresholds of sensation, urge and discomfort (40 cm3 , 70 cm3 , and 140 cm3 , respectively) were significantly higher than those in the C group (20 cm3 , 30 cm3 , and 85 cm3 , respectively;P < 0.001). In the NRFI group, 62.5% presented a mean resting pressure above the fifth percentile, and 82.5% of patients presented a maximum squeeze pressure above the fifth percentile. The comparisons between segments obtained from these patients and thoseobtained from the C group revealed several segments with significantly decreased pressure values in the NRFI group.
Conclusions:Our study demonstrated lower pressure parameters in children with NRFI. In patients with normal resting pressures, 3D-HRAM may reveal segments with decreased pressures, which may play a potential role in the pathomechanism of incontinence.
