Anal endosonography in healthy subjects and patients with idiopathic fecal incontinence

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Abstract
This study investigates the normal ultrasono graphic morphology of pelvic floor striated muscle and evaluates whether there are differences between males and females and between healthy subjects and patients with idiopathic fecal incontinence. Manometric and ultrasonographic studies of the anal canal were performed in 30 healthy volunteers and in 26 patients with idiopathic fecal incontinence. Verification of ultrasonographic findings was obtained by studying anatomic preparations. Ultrasonography reliably identified the internal and external anal sphincter and frequently visualized neighboring structures. In addition, it detected muscular structures that have not clearly been described previously. However, differences in external sphincter function between males and females and between healthy subjects and incontinent patients were not reflected by alterations in muscle thickness. Endosonography of the anal canal clearly delineates muscular structures and may even visualize structures that have been previously incompletely defined. However, it remains to be shown that differences in certain muscular functions have a morphologic correlate that can be detected by endosonography.