Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Manometry”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1996

Anorectal manometry before, during and after estrogen replacement therapy.

The incidence of relaxation of the pelvic floor increases with age, and although a relation between prolapse and the decline of estrogens has been suggested, there is no objective evidence. Together with urodynamic measurements, anal manometry is one of the few ways of making an objective assessment of the strength of pelvic structures located in and near the pelvic floor. In order to study the role of estrogens, anal manometry was performed before, during and after estrogen replacement therapy with daily oral use of 0.625 mg conjugated estrogens for 6 months. Five postmenopausal women, who had not used estrogen replacement therapy in the past, were included in the study. None of the manometric parameters, including maximal anal resting pressure, maximal squeeze pressure and internal anal sphincter response, changed. It was concluded that estrogens have no effects on manometric parameters of the external sphincter and that anal manometry may not be the appropriate method to assess the effects of estrogens on the pelvic floor.

Age Factors↗
PubMed1995

Is manometry essential for surgery of chronic fissure-in-ano?

PURPOSE: Although many studies reported the association between high anal sphincter pressures and anal fissures, one question is open to date: is manometry really necessary for surgical management/does manometry influence the outcome? METHODS: Between October 1, 1990 and December 31, 1991, lateral sphincterotomy was performed in 177 patients with chronic anal fissure. In all patients the operation was performed as an outpatient procedure under local anesthetic. Electromanometry of the anal canal was carried out preoperatively to demonstrate the raised resting pressure profile within the anal canal. At the same time the maximum squeezing pressure was determined by electromanometry, and electromyography was performed to detect dysfunction of the external sphincter or the levators. The control group consisted of 14 proctologically healthy patients with a resting pressure of 74.4 +/- 8.9 and a maximum squeezing pressure of 130.2 +/- 15 (cm H2O). On the basis of resting pressures determined in healthy patients, an upper limit of 90 was defined as normal, taking into account the standard deviation and standard error rate. For statistical comparison patients were divided into two groups, retrospectively. All patients in Group A had a resting pressure of < or = 90, and all patients in Group B had a resting pressure of > 90. Six weeks after operation electromanometry was again performed to determine the resting pressure profile and maximum squeezing pressure of the sphincter system, and patients were examined to determine whether the fissure had healed. RESULTS: As a result of the lateral sphincterotomy, the resting pressure was lowered in all patients from 106.6 +/- 21.5 to 80.9 +/- 10.4 and maximum squeezing pressure from 149.3 +/- 27.6 to 135.3 +/- 27.2. Both results were highly significant (P < 0.001, chi-squared). Regarding either reduction in postoperative resting pressure or continence, Groups A and B did not differ statistically. In Group A soiling occurred in 3.2 percent and Grade 1 incontinence in 3.2 percent (1 patient each), and in Group B only one patient (0.7 percent) complained of soiling. Recurrences occurred in 9.7 percent of patients in Group A and in 2.1 percent of patients in Group B (3 patients in each case). CONCLUSION: Electromanometric examinations showed that internal sphincterotomy significantly reduces pressure within the anal canal, thus permitting the anal fissure to heal. No significant continence problems were observed. Although manometric selection of patients leads to different results regarding both postoperative continence and recurrence, these differences are not statistically significant. Therefore, it follows that, in experienced hands and using a standardized technique, manometry before surgical management of anal fissure by lateral sphincterotomy is probably superfluous.

Adult↗
PubMed1997

Anal endosonography and manometry: comparison in patients with defecation problems.

PURPOSE: Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. METHODS: For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. RESULTS: Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. CONCLUSION: Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

Adult↗
PubMed1993

Dynamic anal manometry in the assessment of patients with obstructed defecation.

Patients with obstructed defecation show no consistent abnormalities when assessed by standard anorectal physiologic methods. With a recently developed technique for dynamic anal manometry, we studied 13 female patients with obstructed defecation and 20 healthy volunteers. Seven parameters of anal function were measured. There were no differences between the median values for the two groups. Seven patients (54 percent; 95 percent confidence limits, 25-81 percent) had anal compliance below the normal range, either during opening or closing of the sphincter at rest (five patients), during squeeze (one patient), or both (one patient). Opening and closing pressures of the sphincter at rest, maximal closing pressure during squeeze, and anal hysteresis were normal. Standard anal manometry did not show any differences between patients and controls. Rectal compliance was lower in patients with obstructed defecation, median difference 5 ml/cm H2O (95 percent confidence limits, 1-9 ml/cm H2O). In conclusion, the more detailed method of dynamic anal manometry shows that some patients with obstructed defecation have a less compliant anal sphincter and a less compliant rectum, but in many patients no abnormal findings can be made.

Adult↗
PubMed1995

Ampulla of Vater/duodenal wall spasm diagnosed by antroduodenal manometry.

Patients with chronic epigastric to right upper quadrant pain are often considered to have gallbladder of sphincter of Oddi dysfunction, but standard tests are nondiagnostic. In 62 consecutive patients with this compliant undergoing antroduodenal manometry, we correlated a change on duodenal motility with spasm of the ampulla of Vater/duodenal wall. This distinctive motility pattern occurred and was analyzed in 35% of patients. It is characterized by increased duodenal wall tone with phasic contractions of 19-22 or 41-44 contractions/min or by phasic activity alone. The subjects with spasm also underwent cholecystokinin cholescintigraphy, and 50% showed either significantly delayed gallbladder emptying of hilum to small intestine emptying, or both. The disorder appears to be secondary to a loss of neural inhibitory control and a dysfunctional small-bowel pacemaker. Antroduodenal manometry is an essential diagnostic procedure that complements sphincter of Oddi manometry in evaluation of unexplained right upper quadrant pain.

Abdominal Pain↗
PubMed1992

Normal variation in anorectal manometry.

A study was performed to define the normal range of values for anorectal manometry. Normal volunteers were divided according to gender and parity. There were 20 males, 21 nulliparous females, and 18 multiparous females among the 59 subjects. Anorectal manometry using a radial eight-port catheter was performed during resting and squeezing maneuvers of the anal sphincter. Computerized data analysis and three-dimensional imaging were used to calculate sphincter length at rest and squeeze, mean maximum resting and squeeze pressures, and vector symmetry index. The sphincter length at rest and with squeezing in males was significantly greater compared with the two female groups (P < 0.007). Mean maximum squeeze pressures were also significantly elevated in the male group compared with the female groups (P = 0). Mean maximum resting pressures were significantly higher in nulliparous women than in multiparous women (P = 0.04). However, no difference in resting pressures was found between males and nulliparous females. A comparison of the symmetry of the anal canal revealed no differences among the three groups. Ranges for normal anorectal manometry are definable. Normal ranges are distinct for subgroups of patients, particularly with regard to gender and parity. Patients must be compared with their normal subgroups to correctly identify manometric abnormalities.

Adult↗
PubMed1997

Clinical value of anorectal manometry index in neurogenic fecal incontinence.

PURPOSE: The present communication is an endeavor to assess the value of a simple motility index to separate patients with neurogenic or idiopathic fecal incontinence from those patients with the secondary form of the disease. METHODS: Study population consisted of 23 patients with idiopathic fecal incontinence and 13 patients with fecal incontinence secondary to surgical or obstetric trauma. They all had a standard anorectal manometric study after a 12-hour fast. A motility index was then prepared taking into consideration the peak sphincter pressure values, contractility endurance, and rectal sensory threshold. RESULTS: Despite differences in the mean peak squeeze pressure and sensory threshold between the two groups, there were significant overlaps for all parameters of standard anorectal manometry in both groups. However, patients with idiopathic incontinence had an index of smaller than 28, and the group with the secondary form of incontinence had indexes higher than 30. CONCLUSIONS: 1) None of the four parameters of a conventional anorectal manometry can accurately separate patients with neurogenic incontinence from those with secondary forms of the disorder. 2) The anorectal motility index presented here can accurately separate the two groups. 3) This index is superior to the standard anorectal manometry in evaluating patients with fecal incontinence.

Aged↗
PubMed1983

A simple method of anorectal manometry.

Anorectal manometry is usually performed with an open-tipped tube or a closed balloon system. To overcome the well known measurement problems and errors associated with fluid-filled catheter systems and balloons, a pressure tranducer was used to perform anorectal manometry. This method, performed on more than 200 individuals with different anorectal disorders, is described. This was found to be a simple, reliable and reproducible method for anorectal manometry.

Anus Diseases↗
PubMed1986

Colonic transit time of radiopaque markers and rectoanal manometry in patients complaining of constipation.

Transit time, rectoanal manometry, and symptoms were studied in 61 patients complaining of constipation. A slow transit, in the colonic area of most of the patients, was found in 49. Rectoanal manometry was abnormal in 40. Both examinations were abnormal in 32 patients, colonic transit only in 17, and manometry only in eight. Finally, both examinations were normal in only four subjects. A transit delay was always associated with less than three stools per week, and straining at stool was constant when rectoanal manometric disturbances were shown. Objective abnormalities appear common in patients complaining of constipation and, correlated with symptoms, suggest that clinical study in constipation could be of more value than usually is believed.

Adolescent↗
PubMed1996

Intraoperative esophageal manometry and fundoplications: prospective study.

The purpose of this study was to validate the use of intraoperative manometry for assessing fundoplication and to search for predictive manometric criteria. This prospective study concerned 48 patients operated for gastroesophageal reflux. The manometry was carried out pre- and intraoperatively for all patients and postoperatively as well for 30 patients. The operative procedures were total fundoplication (n = 25) and posterior (partial) fundoplication (n = 5). The lower esophageal sphincter (LES) pressures and lengths were similar in the preoperative and intraoperative measurements before any esophageal mobilization, whereas the intraoperative LES pressure was significantly higher after fundoplication. The mean postoperative LES pressure decreased by 50 +/- 19% compared with the intraoperative pressure after fundoplication. The final intraoperative pressures of two dysphagic patients were not the highest of the study. More importantly, their final intraoperative pressures were 7.5 and 8.2 times the initial pressure, respectively, which was significantly greater than the intraoperative pressure increase of the nondysphagic patients (4.6 +/- 2.0 times). The final intraoperative pressure of the only patient with recurrence (18.2 mmHg) was the lowest of the study. In conclusion, intraoperative manometry is an effective method for evaluating the LES, and it could have predictive value for the surgical management of gastroesophageal reflux disease.

Esophagus↗
PubMed2001

Three-dimensional pressure imaging: a novel method for intraoperative manometry during laparoscopic esophagomyotomy for esophageal achalasia.

With the introduction of computerized manometry, the creation of the three-dimensional (3-D) pressure image with measurement of pressure vector volume (PVV) has become available to assess the pressure structure of the high-pressure zone (HPZ) of the distal esophagus. We have applied this technique to intraoperative manometry during laparoscopic surgery for esophageal achalasia (EA). A laparoscopic esophagomyotomy with anterior fundoplication was performed in a 12-year-old boy with EA. Computerized 3-D images were obtained by a stepwise pullback of a manometric assembly with eight radial side-holes to quantitate the PVV of the HPZ of the distal esophagus in each stage of the operation for EA. Virtual abolishment of the peak pressure image and a marked reduction in the PVV after esophagomyotomy suggested appropriate decompression of the HPZ. Intraoperative manometry using computerized 3-D pressure imaging with measurement of the PVV is thus useful to assess the HPZ during laparoscopic surgery for EA.

Child↗
PubMed2006

Preoperative anal manometry predicts continence after perineal proctectomy for rectal prolapse.

PURPOSE: This study examines whether preoperative anal manometry and pudendal nerve terminal motor latency predict functional outcome after perineal proctectomy for rectal prolapse. METHODS: All adult patients treated by perineal proctectomy for rectal prolapse from 1995 to 2004 were identified (N = 106). Forty-five patients underwent anal manometry and pudendal nerve terminal motor latency testing before proctectomy and they form the basis for this study. RESULTS: Perineal proctectomy with levatoroplasty (anterior 88.9 percent; posterior 75.6 percent) was performed in all patients, with a mean resection length of 10.4 cm. Four patients (8.9 percent) developed recurrent prolapse during a 44-month mean follow-up. Preoperative resting and maximal squeeze pressures were 34.2 +/- 18.3 and 60.4 +/- 30.5 mmHg, respectively. Pudendal nerve terminal motor latency testing was prolonged or undetectable in 55.6 percent of patients. Grade 2 or 3 fecal incontinence was reported by 77.8 percent of patients before surgery, and one-third had obstructed defecation. The overall prevalence of incontinence (77.8 vs. 35.6 percent, P < 0.0001) and constipation (33.3 vs. 6.7 percent, P = 0.003) decreased significantly after proctectomy. Patients with preoperative squeeze pressures >60 mmHg (n = 19) had improved postoperative fecal continence relative to those with lower pressures (incontinence rate, 10 vs. 54 percent; P = 0.004), despite having similar degrees of preoperative incontinence. Abnormalities of pudendal nerve function and mean resting pressures were not predictive of postoperative incontinence. CONCLUSIONS: Perineal proctectomy provides relief from rectal prolapse, with good intermediate term results. Preoperative anal manometry can predict fecal continence rates after proctectomy, because patients with maximal squeeze pressures >60 mmHg have significantly improved outcomes.

Adult↗
PubMed2006

Anal manometry: a comparison of techniques.

PURPOSE: Methods of anal manometry vary between centers, resulting in potential difficulties in interpretation of results. This study compared several accepted manometric techniques in healthy control subjects and in patients with fecal incontinence. METHODS: Eleven patients with fecal incontinence (M:F = 3:8; mean age = 67 years) and ten healthy control subjects (M:F = 3:7; mean age = 64 years) underwent anal manometry using five different methods: 1) water-perfused side hole; 2) water-perfused end hole; 3) microtransducer; 4) microballoon; 5) portable Peritron. Using a station pull-through technique, anal pressures (resting, squeeze, and cough pressures) were recorded at 1-cm intervals from rectum to anal verge, as well as radial pressures in four quadrants for Methods 1 and 2. RESULTS: Water perfusion side hole recorded slightly higher maximal resting pressures; however, there were no significant differences between any of the methods. In healthy control subjects, distal maximal squeeze pressures were significantly higher (P < 0.05) than proximally as measured by microtransducer. There were slight (nonsignificant) variations in radial pressures with water perfusion and microtransducer. Peritron values for maximum resting pressure and maximum squeeze pressure were lower than those recorded by water perfusion side hole by a factor of 0.8. CONCLUSIONS: There is no significant variation in anal pressure recordings using standard manometry techniques. Variations in radial pressures are slight and not significant in clinical studies. Results obtained with portable nonperfusion systems must be interpreted appropriately.

Aged↗
PubMed2005

Biliary scintigraphy versus sphincter of Oddi manometry in patients with post-cholecystectomy pain: is it time to disregard the scan?

Sphincter of Oddi (SO) dysfunction is diagnosed using manometry, and patients with an abnormal SO basal pressure respond well to division of the SO. However, manometry is invasive and is associated with a low, yet significant, incidence of complications. Scintigraphy techniques have been developed with the aim of providing a noninvasive means of assessing SO motility. However, when compared with SO manometry these techniques fall short in sensitivity and specificity for diagnosing SO dysfunction. Furthermore, they do not select patients who will respond to treatment. Consequently, the quest for development of a noninvasive investigation for diagnosis of SO dysfunction continues. In the mean time, improved manometric techniques that enhance reproducibility and reduce complications have been developed.

Biliary Tract↗
PubMed1989

Esophageal dysfunction and chest pain in patients with mitral valve prolapse: a prospective study utilizing provocative testing during esophageal manometry.

PURPOSE: The cause of chest discomfort in patients with mitral valve prolapse (MVP) remains unknown. Our aim was to determine prospectively the incidence of esophageal disorders and abnormal responses to edrophonium chloride and esophageal acid infusions in patients with MVP and troublesome non-ischemic chest pain. PATIENTS AND METHODS: After coronary artery disease was excluded, 20 patients with MVP and chest pain underwent esophageal manometry and provocative testing with edrophonium chloride and acid infusion. Seven patients with MVP but without chest pain served as control subjects; they also underwent esophageal manometry with provocative testing. RESULTS: Esophageal manometry revealed esophageal disorders in 16 patients: diffuse esophageal spasm in 14 patients, nutcracker esophagus in one, and hypotensive lower esophageal sphincter in one. Esophageal motility was normal in four patients. Injection of edrophonium and acid infusion tests evoked typical chest discomfort in three of 18 and five of 19 patients, respectively. In six of seven control subjects with MVP but with no chest discomfort, esophageal motility was normal and provocative testing did not produce chest discomfort (p less than 0.05 versus results in patients). CONCLUSION: Esophageal disorders were common and may account for chest discomfort in certain patients with MVP and persistent chest pain syndromes.

Adult↗
PubMed1992

Manometry can predict feeding readiness in preterm infants.

To assess the usefulness of duodenojejunal manometry in predicting when neonates will tolerate enteral feeding, small intestinal manometry was performed in 48 preterm infants. Characteristics of motor activity during fasting and feeding differed in 40 infants who were identified to be tolerant and 8 who were intolerant of feeding. Among infants who were feeding intolerant, motor quiescence was less pronounced and clustered motor activity more prominent than it was in infants who were able to tolerate feedings (P < 0.005). Those infants who tolerated feedings changed their pattern of motor activity in response to feeding (P < 0.01), and infants who did not tolerate feedings had no "fed response." Infants who were initially feeding intolerant became tolerant of feedings coincident with the appearance of motor activity that was similar to that of infants who were initially tolerant to food. The sensitivity of manometry to predict feeding intolerance was 1.0, and its specificity was 0.13.

Duodenum↗
PubMed2004

A pilot study using total colonic manometry in the surgical evaluation of pediatric functional colonic obstruction.

BACKGROUND/PURPOSE: Total colonic manometry (TCM) can directly measure intraluminal pressures and contractile function of the entire colon. The utility of TCM to guide the surgical management of functional colonic obstruction has not been reported. METHODS: Total colonic manometry was performed on all patients referred for surgical evaluation of refractory functional colonic obstruction. Manometric tracings were obtained while fasting, after feeding, and after pharmacologic stimulation. RESULTS: Nine patients were referred for refractory colonic obstruction. The mean age was 4.8 years, and the mean duration of follow-up was 29 months. Two patients had functional obstruction after repair of Hirschsprung's disease, and 7 patients had idiopathic functional obstruction. In the idiopathic group, 4 distinct motility patterns were identified: (1) normal colonic motility, (2) dysmotility with massive distension, (3) persistent segmental dysmotility, and (4) global neuropathy/myopathy. Both Hirschsprung's patients showed globally abnormal motility. Surgical management was guided by TCM results. There was significant improvement in bowel function and weight gain after manometry-guided intervention. An unnecessary laparotomy was avoided in 2 patients. CONCLUSIONS: TCM can be valuable in deciding the need for and timing of diversion, the extent of resection required, and the suitability of the patient for restoring bowel continuity in refractory functional obstruction.

Adolescent↗
PubMedDate not supplied

Pancreatitis following bile duct sphincter of Oddi manometry: utility of the aspirating catheter.

The aspirating sphincter of Oddi manometry (SOM) catheter was shown to reduce the frequency of post-procedure pancreatitis from 31% to 4% following a pancreatic duct evaluation. This study was designed to prospectively evaluate the utility of the aspirating manometry catheter in reducing the frequency of pancreatic enzyme elevation and clinical pancreatitis following isolated bile duct manometry. Thirty-eight patients were randomly assigned to undergo bile duct SOM with the standard perfusion (infused group) catheter or the aspirating catheter (aspirated group). Overall, the frequency of both amylase and lipase level elevation at least two times the upper limits of normal was 30% at 2 hours, 25% at 6 hours, and 18% at 18 hours after the procedure and was similar for the aspirated and infused groups. No episodes of clinical pancreatitis occurred in either group. The SOM catheter was perfused with full-strength contrast in 12 consecutive patients undergoing a bile duct evaluation. Only one patient had any contrast material identified in the pancreatic duct. The results of this study support the theory that increased pancreatic duct hydrostatic pressure is the major cause for post-SOM pancreatitis and suggests that SOM evaluation of the bile duct alone appears to be safe.

Adult↗