The importance of anorectal physiology tests in clinical diagnosis and treatment

Abstract

AIM: In this study, we aimed to convert subjective findings to objective findings and to determine the effect of anorectal physiology tests on the diagnosis and treatment of patients with defecatory complaints.

MATERIAL AND METHOD: Two hundred and forty patients who applied to the proctology unit between January 2015 and August 2017 were included in our study. The patients were divided into 3 groups based on their presentation complaints; Group 1: Obstructive defecation syndrome(ODS), Group 2: Peroperative except anal incontinence and control after sphincter repair, Group 3: Anal incontinence.Group 2 and Group 3 were divided into subgroups. The demographic data of the patients were retrospectively analyzed. The number of anorectal physiological tests in groups and the rates of referral to surgical or medical treatment were evaluated.

FINDINGS: Two hundred and forty patients were included in our study. The highest mean age was in Group 3 (46.2±17.8) (p: 0.356) 43.3% of the patients in our study were female. Anorectal manometry was performed in all patients. Endoanal USG was most commonly performed in Group 2 (42.6%, p:0.013), defecography in Group 1 (47.4%, p: 0.0001), and EMG in Group 3(25.3%, p: 0,001). In Group 1, 33% of the patients with pathological defecography findings had surgical treatment (p<0.05). In Group 2a, the rate of surgical treatment was higher in patients who underwent anal USG with anorectal manometry (%25.6vs %40). In Group 3, the rate of surgical treatment was higher in patients who underwent anal ultrasound with manometry (%1.9 vs %32.6 p<0.005).

DISCUSSION: Anorectal physiological tests are important for accurate diagnosis and treatment planning. The combined use of anorectal physiological tests in anal incontinence groups increased the rate of referral to surgical treatment.