Abstract
This study investigates whether digital examination of the anal canal can differentiate reliably between competent and incompetent sphincters. Digital examinations were performed by an experienced proctologist who was blinded with regard to the patient's history as well as manometric and endoscopic findings. There was poor correlation between manometric findings and digital assessment of anal sphincter tone. The sensitivity of digital examination for diagnosing incompetent sphincters ranged from 63% to 84%, whereas specificity was calculated as only 57%. It is concluded that even the experienced examiner needs to use more sophisticated methods than digital examination for the evaluation of anal sphincter competence.
Résumé
Ce travail étudie la valeur de l'examen digital du canal anal pour différencier les sphincters compétents et incompétents. Le toucher rectal était effectué par un proctologue expérimenté ne connaissant pas l'histoire du patient ni les résultats manométriques et endoscopiques. Il y avait une mauvaise corrélation entre les résultats manométriques et l'appréciation digitale du tonus du sphincter anal. La sensitivité de l'examen digital pour diagnostiquer l'incompétence sphinctérienne était de 63 à 84%, tandis que la spécificité calculée était de 57%. On en conclut que, même un examinateur expérimenté, a besoin d'utiliser des méthodes plus sophistiquées que l'examen digital pour évaluer la compétence du sphincter anal.
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References
Rosen L (1990) Physical examination of the anorectum: a systematic technique. Dis Colon Rectum 33:439–440
Read NW, Harford WV, Schmulen AC, Read MG, Santa Ana C, Fordtran JS (1979) A clinical study of patients with fecal incontinence. Gastroenterology 76:747–756
Eckardt VF, Elmer T (1991) Reliability of anal pressure measurements. Dis Colon Rectum 34:72–77
Kaushal JN, Goldner F (1991) Validation of the digital rectal examination as an estimate of anal sphincter squeeze pressure. Am J Gastroenterol 86:886–887
Felt-Bersma RJF, Klinkenberg-Knol EC, Meuwissen SGM (1988) Investigation of anorectal function. Br J Surg 75:53–55
Hallan RI, Marzouk DEMM, Waldron DR, Womack NR, Williams NS (1989) Comparison of digital and manometric assessment of anal sphincter function. Br J Surg 76:973–975
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Eckardt, V.F., Kanzler, G. How reliable is digital examination for the evaluation of anal sphincter tone?. Int J Colorect Dis 8, 95–97 (1993). https://doi.org/10.1007/BF00299335
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DOI: https://doi.org/10.1007/BF00299335