ANORECTAL INCONTINENCE : CLINICAL, IMAGING AND MOTILTY STUDY

Abstract

Continence is a complex function maintained by the interaction of

multiple mechanisms, including stool consistency and delivery of colonic

I . contents to the rectum, rectal capacity and compliance, anorectal sensation, I . the function of the anal sphincter mechanism, and the pelvic noor muscle

and nerves. Disruption of any part of this system may result in incontinence.

This study was undertaken to investigate the relative prevalence of I i. anorectal incontinence at our institution and to analyze the value of di!Terent diagnostic modalities as well as the results of various management options of patients with anorectal incontinence.

The material of the current study composed of 87 patients with anorectal incontinence treated at the Department of Surgery, Tanta University Hospital during the period fi•orn May 1997 to January 2000. These patients constituted about 2.24% of the total admissions at the department of surgery during the period of the study. Each patient was subjected to full clinical history, through clinical examination and to some or 1• all various investigations, including cndoanal ultrasound, anorectal motility l study, electrogalvanic stimulation, EMG, CT, MRI, lower GI contrast study and colonoscopy according to the feasibility and the specific need for such diagnostic tools .

The overall male to female ratio was 1.4:l. Female preponderance

was noted among adults (male to female ratio, I:1.5). Double urinary and . , fecal incontinence was noted more in females than males (22.2% versus 6.8%).