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Review
. 2021 Jan;34(1):15-21.
doi: 10.1055/s-0040-1714246. Epub 2020 Sep 4.

Anorectal Physiology Testing for Prolapse-What Tests are Necessary?

Gifty Kwakye  1 , Lillias Holmes Maguire  1
Affiliations
Review

Anorectal Physiology Testing for Prolapse-What Tests are Necessary?

Gifty Kwakye et al. Clin Colon Rectal Surg. 2021 Jan.

Abstract

Rectal prolapse frequently occurs in conjunction with functional and anatomic abnormalities of the bowel and pelvic floor. Prolapse surgery should have as its goal not only to correct the prolapse, but also to improve function to the greatest extent possible. Careful history-taking and physical exam continue to be the surgeon's best tools to put rectal prolapse in its functional context. Physiologic testing augments this and informs surgical decision-making. Defecography can identify concomitant middle compartment prolapse and pelvic floor hernias, potentially targeting patients for urogynecologic consultation or combined repair. Other tests, including manometry, ultrasound, and electrophysiologic testing, may be of utility in select cases. Here, we provide an overview of available testing options and their individual utility in rectal prolapse.

Keywords: anorectal physiology; defecography; manometry; prolapse.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Example of an anorectal manometry probe showing location of sensors (Copyright John Wiley & Sons Licensed Content Publisher. All rights reserved. Reproduced by permission).
Fig. 2
Fig. 2
Series of high-resolution and conventional manometry tracings of attempted defecation in healthy individuals (top panel) and in patients exhibiting the four different types of dyssynergic defecation (Copyright Journal of Neurogastroenterology and Motility. All rights reserved. Reproduced by Permission).
Fig. 3
Fig. 3
Fluoroscopic defecography in a healthy patient at rest ( A ), squeeze ( B ) with arrow indicating impression created by the puborectal sling, ( C ) strain against closed sphincters, and ( D ) evacuation. Note changes in the anorectal angle during each study phase as indicated by the arrow (Copyright Journal of Neurogastroenterology and Motility. All rights reserved. Reproduced by Permission).
See this image and copyright information in PMC

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