Pelvic Floor Disorders Clinical Trial
Official title:
Correlation of Anal Acoustic Reflectometry Parameters With Degree of Rectal Intussusception and Prolapse
Anal Acoustic Reflectometry (AAR) is a reliable and reproducible technique that has been
studied in our department over the last 6 years. Sound waves pass into a balloon placed in
the anal canal and are used to measure the cross-sectional area. By gradually increasing and
decreasing the pressure in the balloon the investigators can measure the pressure at which
the cross-sectional area starts to increase and decrease, and the anal canal starts to open
and close. This assessment mimics the natural opening and closing of the anal canal and the
effect of squeezing the muscles.
Rectal intussusception occurs when the rectal wall telescopes into itself distally and is
termed prolapse when it protrudes through the anal canal. Not all patients will require
surgery and, for some, it can lead to debilitating symptoms of constipation, pain and faecal
incontinence. Currently, the Oxford grading system through radiological testing is used for
classifying severity of rectal intussusception and prolapse; however this does not give us
sufficient information about the anal sphincter muscles.
The gold standard investigation of the anal sphincter muscles has been manometry which
measures anal canal pressure at rest and during squeeze. However, it has limitations. In
previous studies AAR has shown promise in the assessment of faecal incontinence and, that
unlike manometry, it has been able to distinguish between different types of incontinence.
Thus far, it has not been studied in patients with rectal intussusception and it is hoped
that AAR parameters may provide an indication of when rectal intussusception becomes overt
rectal prolapse. This can inform the clinician to guide further management of a group of
patients with a condition that can have significant impact on quality of life.
This an observational study based on not intervention. Patients are grouped depending on grade of prolapse, and all undergo the routine AAR investigation. Patients are grouped solely on differences in pathology already present and not on any intervention. ;
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