Manometric asymmetry in the anal canal in controls and patients with fecal incontinence

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Abstract
This study was designed to ascertain the existence of manometric asymmetry in the anal canal in controls and in patients with fecal incontinence. A computerized manometric technique with an eight-channel perfusion catheter was used. Coefficient of variation (CV, a mathematical expression of the degree or magnitude of deviation of a set of data points from the mean) was developed in this study as an index of anal canal manometric asymmetry. At 1 cm from the anal verge, mean CV was 9.3 and 8.7 percent in asymptomatic control males and females, respectively. During a maximum voluntary squeeze effort, mean CV in control males was 9.3 percent and was not significantly different (P=0.28) from that in control females (7.8 percent). In 14 consecutive female patients with fecal incontinence, mean CV at rest (1 cm from the anal verge) was 21 percent and was significantly higher (P<0.01) than in control females. Similarly, during a maximum voluntary squeeze effort, mean CV in patients with fecal incontinence was 20.5 percent and was significantly higher (P<0.01) than in the female control group (7.8 percent). It is concluded that CV, a method of expressing anal sphincter manometric asymmetry, is a useful manometric parameter in the assessment of anorectal function.