[Methods of anorectal functional studies]

Abstract

The currently available methods of anorectal functional investigation are critically reviewed. The clinical utility of manometry has not yet been precisely defined, and the method is not standardized. The principal role of manometry is comparison between defined groups, such as preoperative and postoperative, whereas determination of the degree of continence has proven not more accurate than clinical digital investigation. The latter serves to determine qualitatively all important functions of the anal sphincter components. Radiological dynamic investigations may detect and differentiate various forms of anorectal constipation (outlet obstruction, internal prolapse, rectocele). While electrophysiological studies are not currently used in clinical practice, they demonstrate the importance of pudendal nerve damage in pelvic floor disorders and incontinence. Electromyography may be used to identify the activity of the sphincter components. Clinical investigation may provide detailed and adequate qualitative information on anorectal function.