Obstructed defecation: the role of anorectal manometry.

BACKGROUND

The aim of the study was to evaluate the clinical usefulness of anorectal manometry (AM) in patients affected by obstructed defecation (OD).

METHODS

Between January 2007 and December 2010, 379 patients (287 women and 92 men) affected by OD were evaluated. After a preliminary clinical evaluation, defecography and AM were performed. The results were compared with those from 20 healthy control subjects.

RESULTS

Overall anal resting pressure was not significantly different between patients and controls. Maximal voluntary contraction (MVC) data were significantly lower when compared with those of controls (P < 0.01). The straining test was considered positive in 143 patients. No significant difference was noted between patients and controls in maximal tolerated volume data. Patients had a significantly higher conscious rectal sensitivity threshold than controls (P < 0.02).

CONCLUSIONS

A positive straining test, low MVC and impaired rectal sensation are the main abnormalities detected by AM in patients with OD.