Endoanal ultrasonography in the diagnosis of anal incontinence

Endoanal ultrasonography with a Bruel and Kjaer 7 mHz rotative probe allows precise evaluation of the different structures of the anus, the anal canal and the rectum. The integrity thickness and length of the muscle layers call be measured in a reproducible way during contracture and at rest. In addition to the classic images, video recording can be carried our. We examined 96 consecutive patients with anal incontinence, comprising 82 female and 14 male patients. In 76 cases the origin were an obstetrical lesion, 7 were surgical lesions, in 9 cases the lesion was posttraumatic and in 2 cases a malformation. In 2 cases a rectal prolapse was associated. We found that endoanal ultrasonography permits a precise diagnosis of anal incontinence. The nature and the extent of sphincteric lesions can be determined and the surgical procedure can thus be planned. In the absence of organic lesions this examination serves to avoid unnecessary surgical treatment.