Although bidets are widely used in Korea, its effects on anorectal pressures have not been studied in detail in terms of the water settings used. Twenty healthy volunteers were placed on a toilet equipped with a bidet, and anorectal pressures were measured with a manometry catheter inserted into the rectum and anal canal before and after using the bidet at different water forces (40, 80, 160, 200 mN), temperatures (24degrees C vs 38degrees C), and water jet widths (narrow vs wide). The pressure at anal high pressure zone decreased from 96.1 +/- 22.5 to 81.9 +/- 23.3 mmHg at water jet pressure of 40 mN and 38degrees C wide water jet (P < 0.001), from 94.3 +/- 22.4 to 80.0 +/- 24.1 mmHg at water jet pressure of 80 mN and 38degrees C narrow water jet (P < 0.001), and from 92.3 +/- 22.4 to 79.6 +/- 24.7 mmHg at a water jet pressure of 80 mN and 38degrees C wide water jet (P < 0.001). At other settings, no significant changes were observed. Our results indicate that, in addition to cleansing effect, bidet could be used to reduce anal resting pressure in the same manner as the traditional warm sitz bath under the conditions of low or medium water jet pressure, a warm water temperature, and a wide type water jet.
Adult ; Anal Canal/physiology ; Female ; Humans ; Male ; Manometry ; Pressure ; Rectum/*physiology ; Temperature ; *Toilet Facilities ; Water

Although bidets are widely used in Korea, its effects on anorectal pressures have not been studied in detail in terms of the water settings used. Twenty healthy volunteers were placed on a toilet equipped with a bidet, and anorectal pressures were measured with a manometry catheter inserted into the rectum and anal canal before and after using the bidet at different water forces (40, 80, 160, 200 mN), temperatures (24degrees C vs 38degrees C), and water jet widths (narrow vs wide). The pressure at anal high pressure zone decreased from 96.1 +/- 22.5 to 81.9 +/- 23.3 mmHg at water jet pressure of 40 mN and 38degrees C wide water jet (P < 0.001), from 94.3 +/- 22.4 to 80.0 +/- 24.1 mmHg at water jet pressure of 80 mN and 38degrees C narrow water jet (P < 0.001), and from 92.3 +/- 22.4 to 79.6 +/- 24.7 mmHg at a water jet pressure of 80 mN and 38degrees C wide water jet (P < 0.001). At other settings, no significant changes were observed. Our results indicate that, in addition to cleansing effect, bidet could be used to reduce anal resting pressure in the same manner as the traditional warm sitz bath under the conditions of low or medium water jet pressure, a warm water temperature, and a wide type water jet.
Adult ; Anal Canal/physiology ; Female ; Humans ; Male ; Manometry ; Pressure ; Rectum/*physiology ; Temperature ; *Toilet Facilities ; Water

OBJECTIVESTo assess the tendency of manometric asymmetry, and to quantitatively evaluate the function of the anal sphincter.

METHODSUsing the PC polygram HR at the states of relax and squeeze, we compared the values of pressure asymmetry in the anorectum of 27 normal children with that of 12 children with fecal incontinence.

RESULTSIn the two states, the anal sphincter in normal children showed not only the gradient of pressure, but also a gradient of pressure asymmetry. Children with fecal incontinence did not show any gradients.

CONCLUSIONGradients of pressure and pressure asymmetry can quantitatively evaluate the function of the anal sphincter.

Adolescent ; Anal Canal ; physiology ; Child ; Child, Preschool ; Fecal Incontinence ; physiopathology ; Female ; Humans ; Male ; Manometry ; Rectum ; physiology

OBJECTIVETo investigate the change pattern of substance P (SP) in the portal vein during the rectoanal inhibitory reflex (RAIR), and its physiologic significance; the influence of external splanchnic nerve of rectum and anal to the RAIR.

METHODSThe rats were divided into seven groups, among them there were six groups, which were first divided into two big groups according to whether the external splanchnic nerve to the rectum and anal were cut off, one is no cut-off external splanchnic nerve group, the other is cut-off external splanchnic nerve group. Each group were further divided, according to the distance of the balloon-sac on Foley's tube in the rectum away from anal verge, into 2, 4, 6 centimeter groups; A control group with Foley's tube put into the rectum, but the balloon-sac on Foley's tube did not pumped up with water. Measure and compare the value and change of SP in the portal vein during the RAIR.

RESULTSThe comparison of SP in portal vein, among the 2, 4 centimeter groups with cut-off external splanchnic nerve, all groups with intact external splanchnic nerve supply and control group, had no statistic difference (P>0.05). The comparison between the 6 centimeter group with intact external splanchnic nerve group and the 2, 4 centimeter groups with cut-off external splanchnic nerve, P<0.01, the statistic difference was significant. The comparison between 6 centimeter group of intact and cut-off external splanchnic nerve, P<0.01, the difference was significant.

CONCLUSIONThe reason for the stimulation on upper rectum dose not induce the RAIR is related with this stimulation result in the release of SP, the exciting mediator to internal sphincter. The external splanchnic nerve supply of rectum and anal canal have influence on the change of SP of the portal vein during RAIR.

Anal Canal ; physiology ; Animals ; Female ; Male ; Portal Vein ; physiology ; Rats ; Rats, Sprague-Dawley ; Rectum ; physiology ; Substance P ; metabolism

BACKGROUNDNerve-sparing radical hysterectomy (NSRH) was developed in an attempt to minimize complications after radical hysterectomy. Since 2008, a modified NSRH-nerve plane-sparing radical hysterectomy (NPSRH) has been developed at the Cancer Hospital, Chinese Academy of Medical Sciences. The aim of this study was to investigate the role of NPSRH in improving postoperative pelvic visceral dysfunctions.

METHODSEighty-three patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA2 cervical cancer received NPSRH (the study group) from January 2008 to October 2012. One hundred and sixty-six patients who underwent conventional radical hysterectomy (CRH) were randomly selected as the control group. Age, pathological type and stage were matched between the two groups. The safety of surgery was assessed by duration of operation and blood transfusion rate. Postoperative short-term bladder function was analyzed by duration of catheterization. Long-term bladder, anorectal and sexual function were evaluated with questionnaires.

RESULTSSeventy-eight patients (94.0%) in the NPSRH group and one hundred and sixty patients (96.4%) in the CRH group completed the study. Median follow-up time was 31.9 months and 31.0 months respectively (P = 0.708). There was no significant difference between the two groups in terms of age, body mass index, FIGO stage, pathologic type, preoperative and postoperative therapy (P > 0.05). The blood transfusion rate shared no difference between two groups (P = 0.364). The operation time in the NPSRH group was significantly longer than CRH group (P < 0.01). But the duration of catheterization and hospitalization in the NPSRH group was significantly reduced compared with CRH group (P < 0.01). In addition, the incidence of long-term urinary frequency, urinary incontinence, urinary retention, straining to void, constipation and diarrhea was significantly lower in the NPSRH group (P < 0.05). However, there was no significant difference regarding sexual function (P > 0.05).

CONCLUSIONSThe current evidence indicated that NPSRH improved long-term bladder function compared to CRH. Moreover, it may improve long-term anorectal function as well.

Anal Canal ; physiology ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Rectum ; physiology ; Urinary Bladder ; physiology ; Uterine Cervical Neoplasms ; surgery

A new trichostome ciliate, Balantidium honghuensis n. sp., was isolated from the recta of Rana nigromaculata and R. limnocharis during parasite surveys in Honghu Lake, Hubei Province, central China in summer of 2010 and 2011. Its detailed morphometric characters based on LM and SEM studies were described herein. The organism is oval in shape and thickly ciliated. The vestibulum is "V" shaped and occupies about 1/3 to 2/5 of the body length. The vestibular and nearby regions possess strong peripheral fibers which form a marked axial fiber about the cytopharynx. More than 10 contractile vacuoles are distributed along the periphery of the latter body. Comparisions were made between this new species and B. sinensis Nie, 1935. They were discriminated from each other in terms of general body forms, body size, and vestibulum shapes. Besides, special attention was paid to its high-speed daughter swarmers which we believed to be the infective stage of B. honghuensis. Possible infection routes of anura amphibian balantidia were discussed.
Animals ; Balantidiasis/parasitology/*veterinary ; Balantidium/classification/*isolation & purification/physiology ; China ; Ranidae/*parasitology ; Rectum/*parasitology

Adolescent ; Anal Canal ; physiopathology ; Child ; Constipation ; physiopathology ; Female ; Gastrointestinal Motility ; physiology ; Humans ; Male ; Rectum ; physiopathology

PURPOSE: The aim was to evaluate the discriminating accuracy of anorectal manometry (ARM) between nonconstipated (NC) subjects and functionally constipated (FC) subjects, and between FC subjects with and without functional defecation disorder (FDD). METHODS: Among female patients who visited anorectal physiology unit, those who could be grouped to following categories were included; FC group with FDD (+FDD subgroup), or without FDD (−FDD subgroup) and NC group. ARM was performed and interpreted not only with absolute pressure values, but also pattern classification and quantification of pressure changes in the rectum and anus during attempted defecation. RESULTS: There were 76 subjects in NC group and 75 in FC group. Among FC group, 63 subjects were in −FDD subgroup and 12 in +FDD subgroup. In pattern classification of pressure changes, type 0, as ‘normal’ response, was only slightly more prevalent in NC group than in FC group. When all ‘abnormal’ types (types 1–5) were considered together as positive findings, the sensitivity and specificity of pattern classification in diagnosing FC among all subjects were 89.3% and 22.7%. Those values in diagnosing FDD among FC group were 91.7% and 11.1%. Manometric defecation index (MDI) as a quantification parameter was significantly different between −FDD and +FDD subgroups. Other conventional absolute pressures were mostly comparable between the groups. CONCLUSION: Among all parameters of ARM, MDI was useful to diagnose FDD in FC patients. Other parameters including the pattern classification were questionable in their ability to diagnose FDD.
Anal Canal ; Arm ; Classification ; Constipation ; Defecation* ; Female ; Humans ; Manometry* ; Physiology ; Rectum ; Sensitivity and Specificity

OBJECTIVETo study the value of measuring electrical discharge of external oblique in assessment of young rat model of visceral hypersensitivity.

METHODSEight-day-old neonatal Sprague-Dawley rats were randomly assigned to two groups: an experimental group and a control group (n=16 each). Rats in the experimental group were subjected to mechanical colorectal irritation daily for 7 consecutive days, while the rats in the control group did not received colorectal irritation treatment. On the 6th week of their lives, the spike amplitude of external oblique were measured to evaluate the bowel sensitivity.

RESULTSWhen the colorectal distention (CRD) pressure was 30 and 45 mmHg, the 95% confidence interval of the spike amplitude in the experimental group was significantly higher than that in the control group (P<0.01). When the CRD pressure were 60 and 75 mmHg, the 95% confidence interval of the spike amplitude in female rats was significantly higher than that in males (P<0.05).

CONCLUSIONSThe electrical discharge of external oblique confirmed that chronic colorectal irritation in neonatal rats can result in a chronic visceral hypersensitivity in the juvenile stage, with gender differences. Electrophysiological assessment is a quantitative test, and can objectively reflect visceral sensibility of pain.

Animals ; Colon ; physiopathology ; Disease Models, Animal ; Female ; Irritable Bowel Syndrome ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Rectum ; physiopathology ; Reflex ; physiology

OBJECTIVETo study the expression of Wnt5a protein in the terminal rectum of children with anorectal malformation (ARM) and the possible association between Wnt5a and ARM.

METHODSSpecimens were obtained from 20 children with ARM, 7 children with acquired rectovestibular fistula and 6 children with non-gastrointestinal tract disease (control group). The expression of Wnt5a protein in the terminal rectum was determined by immunohistochemistry and Western blot.

RESULTSWnt5a was mainly expressed in the rectum of the myenteric nerve plexus, mucosal layer and submucosa in the control group. Compared with the control group, Wnt5a expression in the terminal rectum decreased significantly in the ARM group, and decreased more significantly in children with high ARM. The results of Western blot showed the expression of Wnt5a protein in the high, intermediate and low ARM groups were significantly lower than that in the acquired rectovestibular fistula and the control groups (P<0.01). The expression of Wnt5a protein in the high and the intermediate ARM groups were also lower than that in the low ARM group (P<0.01). There was no significant difference in the Wnt5a protein expression between the acquired rectovestibular fistula and the control groups.

CONCLUSIONSThe expression of Wnt5a in the termina1 rectum decreases in children with ARM, suggesting Wnt5a may play an important role in the development of ARM.

Anal Canal ; abnormalities ; Female ; Humans ; Immunohistochemistry ; Infant ; Male ; Proto-Oncogene Proteins ; analysis ; physiology ; Rectum ; abnormalities ; chemistry ; Wnt Proteins ; analysis ; physiology ; Wnt-5a Protein