Absence of effect of nicotine on rectal sensation, rectal compliance, and anal sphincter pressures in healthy subjects

1995 ◽  
Vol 40 (10) ◽  
pp. 2239-2243 ◽  
Author(s):  
Hymie Kavin ◽  
Suzanne Shivley
Keyword(s):  
Anal Sphincter ◽  
Healthy Subjects ◽  
Rectal Compliance ◽  
Rectal Sensation

scholarly journals Acute effects of therapeutic irradiation for prostatic carcinoma on anorectal function

Gut ◽  
1998 ◽  
Vol 43 (1) ◽  
pp. 123-127 ◽  
Author(s):  
E K Yeoh ◽  
A Russo ◽  
R Botten ◽  
R Fraser ◽  
D Roos ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Faecal Incontinence ◽  
Prostatic Carcinoma ◽  
Anorectal Function ◽  
Sensory Function ◽  
Abdominal Pressure ◽  
Rectal Compliance ◽  
Rectal Distension ◽  
Rectal Sensation ◽  
Faecal Urgency

Aim—The incidence of anorectal symptoms after radiotherapy (RTH) for localised pelvic malignant disease is unclear. In addition, the effects of pelvic irradiation on both anorectal motility and sensory function are poorly defined. A prospective study was therefore performed on 35 patients (55–82 years of age) with localised prostatic carcinoma before and four to six weeks after RTH to assess its effects on anorectal function.Methods—Anorectal symptoms were assessed by questionnaire. Anorectal pressures at rest and in response to voluntary squeeze, rectal distension, and increases in intra-abdominal pressure were evaluated with perfused sleeve side hole manometry. Rectal sensation was tested during graded balloon distension. Rectal compliance was calculated by the pressure-volume relation obtained during the testing of rectal sensation. Ultrasound was used to determine anal sphincter structure and integrity.Results—RTH had no effect on anal sphincter morphology. The frequency of defecation increased after RTH (7 (3–21) v 10 (3–56) bowel actions a week; p<0.01). After RTH, 16 patients had faecal urgency and eight faecal incontinence, compared with five and one respectively before RTH (p<0.01 for each). Basal and squeeze sleeve recorded pressures were reduced after RTH (54 (3)v 49 (3) mm Hg (p<0.05) and 111 (8)v 102 (8) mm Hg (p<0.01), before and after RTH respectively; means (SEM)). Rectal compliance was reduced after RTH (1.2 v 1.4 mm Hg/ml, p<0.05). After RTH, threshold volumes for perception of rectal distension were lower in the 16 patients who either experienced faecal urgency for the first time (13 patients) or reported worsening of this symptom (three patients) compared with the remaining patients (34 (4)v 48 (5) ml respectively, p<0.05).Conclusion—Faecal incontinence (23%) is a common problem four to six weeks after RTH for prostatic carcinoma and is associated with minor reductions in anal sphincter pressures. The high prevalence of faecal urgency in patients after RTH may be related to alterations in rectal perception of stool.

scholarly journals Brief communication (Original). Anorectal physiology evaluation after male-to-female sex reassignment surgery

2014 ◽  
Vol 8 (6) ◽  
Author(s):  
Pornthep Pungrasmi ◽  
Jiraroch Meevassana ◽  
Kassaya Tantiphlachiva ◽  
Poonpissamai Suwajo ◽  
Apichai Angspatt ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Anorectal Manometry ◽  
Anorectal Physiology ◽  
Double Layers ◽  
Sex Reassignment Surgery ◽  
Sex Reassignment ◽  
Rectal Sensation ◽  
Female Sex ◽  
Before And After ◽  
Male To Female

AbstractBackground: Male-to-female sex reassignment surgery (MTF-SRS) is a treatment for gender identity disorders (GID) wherein the penis is removed and an epithelialized neovagina is created in the retroprostatic or rectovesical space. This is a space between the double layers of Denonvilliers’ fascia that contains motor, sensory, and autonomic nerves to the pelvic organs. Injury to these nerves may lead to anorectal dysfunction. However, there has been no objective study of anorectal physiologic changes after SRS.Objectives: To compare anorectal physiological parameters, before and after, male-to-female sex reassignment surgery (SRS) and to evaluate the effects of SRS on anorectal physiology.Methods: In 10 patients with MTF GID who underwent SRS at King Chulalongkorn Memorial Hospital, anorectal manometry was performed using a water perfused catheter (Mui Scientific, Ontario, Canada) and a state-of-the-art anorectal manometry system (Medtronic, Minneapolis, MN, USA) at the Gastrointestinal Motility Research Unit at 2 weeks before and 3 months after the SRS. Data were analyzed using PolygramNet software. Anal sphincter pressures (mmHg) with volume used to elicit rectal sensation (mL).Results: There was no significant change in the resting anal sphincter pressure, anal sphincter squeezing pressure, sustained squeezing pressure, and duration of squeeze, rectal sensation, and threshold of the desire to defecate affected by SRS. Cough reflex and rectoanal inhibitory reflex were normal both before and after SRS in all patient participants.Conclusions: Sex reassignment surgery seems to produce no effect on clinical anorectal functions. This was proven by absence of clinically significant changes in anorectal manometry.

scholarly journals Manometric Evaluation of Internal Anal Sphincter after Fissurectomy and Anoplasty for Chronic Anal Fissure: A Prospective Study

2012 ◽  
Vol 78 (5) ◽  
pp. 523-527 ◽  
Author(s):  
Rosalia Patti ◽  
Valentina Territo ◽  
Paolo Aiello ◽  
Giuseppe Livio Angelo ◽  
Gaetano Di Vita
Keyword(s):  
Postoperative Complications ◽  
Anal Fissure ◽  
Anal Sphincter ◽  
Anal Incontinence ◽  
Internal Anal Sphincter ◽  
Healthy Subjects ◽  
Chronic Anal Fissure ◽  
Skin Flap ◽  
Anal Continence ◽  
Squeeze Pressure

Chronic anal fissure (CAF) is a common painful clinical disease and its pathogenesis remains poorly understood. After failure of pharmacological therapy, that is the first-line treatment, surgical sphincterotomy remains the treatment of choice although it is followed by a high rate of anal incontinence resulting from the sphincter damage; therefore, the research of a sphincter-saving surgical option has become an important goal. The aim of this study was to evaluate the manometric modifications and the incidence of anal incontinence after fissurectomy and anoplasty with advancement skin flap in patients affected by CAF with hypertonia of the internal anal sphincter (IAS). Fifteen patients affected by CAF with hypertonia of IAS, unresponsive to medical therapy, were enrolled. All subjects underwent fissurectomy and anoplasty with advancement skin flap. Anorectal manometry was performed preoperatively and after 6 and 12 months from surgery. Maximum resting pressure (MRP), maximum squeeze pressure (MSP), ultraslow wave activity (USWA), fissure healing, anal continence, and postoperative complications were recorded. All patients healed within 30 days from surgery. No intra- or postoperative complications were recorded except for a case of partial donor site break. No significant modifications of MSP were detected. Six months after surgery, MRP was higher with respect to healthy subjects but significantly reduced in comparison to baseline levels. At 12 months, it was higher have versus 6-month values but significantly lower versus preoperative values. USWA was significantly represented in patients with CAF versus healthy subject. Both at 6 and 12 months, they decreased significantly with respect to preoperative values without significant differences versus healthy subjects. Both at 6 and 12 months, anal continence did not differ with respect to preoperative time. The fissurectomy with anoplasty resulted in a high healing rate without surgical sequelae or anal incontinence. Also, it was able to reduce IAS pressure in the same manner as surgical sphincterotomy or forceful dilatation.

scholarly journals Colorectal and rectocolonic reflexes in canines: involvement of tone, compliance, and anal sphincter relaxation

2010 ◽  
Vol 299 (3) ◽  
pp. R953-R959 ◽  
Author(s):  
Ji-Hong Chen ◽  
Hanaa S. Sallam ◽  
Lin Lin ◽  
Jiande D. Z. Chen
Keyword(s):  
Anal Sphincter ◽  
Canine Model ◽  
Proximal Colon ◽  
Fasting State ◽  
Rectal Compliance ◽  
Inhibitory Effects ◽  
Rectal Tone ◽  
Colon Distension ◽  
Induced Changes ◽  
Rectal Distention

Distention of the proximal colon may have inhibitory or excitatory effects on the rectum and vice versa. The reflexes between the proximal colon and the rectum have not been well studied due to difficulties in accessing the proximal colon. The aim of this study was to investigate the reflex responses and their mechanisms between the proximal colon and the rectum in consideration of distention-related changes in tone and compliance of these regions as well as anal sphincter relaxation in a canine model. Proximal colon/rectal tone, compliance, and anal sphincter relaxation were investigated in six dogs chronically implanted with a proximal colon cannula while in the fasting state and during proximal colon distention or rectal distention. It was found that: 1) both rectal distention and proximal colon distention significantly and substantially decreased the compliance of the opposite regions, and guanethidine abolished proximal colon distention-induced changes in rectal compliance; 2) rectal/proximal colon distension decreased proximal colonic/rectal tone, and guanethidine abolished both of these inhibitory effects; 3) the anal sphincter was more sensitive to rectal distention than proximal colon distention; and 4) the minimal distention pressure required to induce anal inhibitory reflex was lower for rectal distention than proximal colon distention. It was concluded that distention-related changes in tone and compliance suggest the long inhibitory reflexes between the proximal colon and the rectum with the sympathetic involvement in rectal responses. The anal sphincter is more sensitive to the distention of the rectum than that of the proximal colon.

The usefulness of anorectal manometry in patients with a stoma before and after surgery to restore the continuity of the gastrointestinal tract

2016 ◽  
Vol 88 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Tomasz Zieliński ◽  
Piotr Czyżewski ◽  
Marek Szczepkowski
Keyword(s):  
Gastrointestinal Tract ◽  
Anal Canal ◽  
Anal Sphincter ◽  
Anorectal Manometry ◽  
Rectal Sensation ◽  
Sphincter Function ◽  
Pressure Threshold ◽  
Increased Risk ◽  
Study Results ◽  
Before And After

AbstractThe operation to restore the continuity of the gastrointestinal tract is another surgical intervention in a given patient, which directly translates into an increased risk of complications during and after surgery. That is why proper qualification is important for the operation to restore the continuity of the gastrointestinal tract in terms of performance and efficiency of the anal sphincter apparatus, among other things.was to evaluate the effect of restoring physiological defecation routes on the sphincter function and to observe the parameters of anorectal manometry in patients before and after surgery to restore the continuity of the gastrointestinal tract.The study included 29 patients scheduled for restoration of the continuity of the gastrointestinal tract, 12 women and 17 men. The average age in the group was 62 years. Anorectal manometry was performed both before surgery as well as one month and three months afterwards in all patients. The average time to have a stoma was 12 months.The resting pressure in the anal canal (MRP) three months after the restoration of the continuity of the gastrointestinal tract increased by 30.4%. The maximum systolic blood pressure in the anal canal (MSP) increased by 22.2%. The value of recto-anal inhibitory reflex (RAIR) decreased by 19.2%. The length of the high pressure zone in the anal canal (HPZL) increased by 27%. The study results of visceral rectal sensation thresholds decreased by 23.3% for the sensation threshold, and 14.4% for the pressure threshold.Restoring the continuity of the gastrointestinal tract improves the anal sphincter function which is evident in the parameters of anorectal manometry. The restoration of passage improves the sphincter function, and these changes are statistically significant.

scholarly journals Transient Anal Sphincter Relaxations Are a Normal Phenomenon in Healthy Subjects

2020 ◽  
Vol 26 (4) ◽  
pp. 552-553
Author(s):  
Jan D Huizinga ◽  
Natalija Milkova ◽  
Ji-Hong Chen
Keyword(s):  
Anal Sphincter ◽  
Healthy Subjects
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