INTRODUCTION AND HYPOTHESIS: This study aims to determine the accuracy of digital rectal examination (DRE) to detect anal sphincter defects when compared to endoanal ultrasound (US) in women with fecal incontinence (FI). METHODS: Seventy-four patients identified by retrospective chart review who presented with complaints of bothersome FI who underwent endoanal US are the subjects of this analysis. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for the ability of the DRE to detect anal sphincter defects. RESULTS: Anal sphincter defect was suspected on DRE in 75%. At endoanal US, external sphincter defects were noted in all three segments in 41% (complete defect) while partial defects were noted in 30%. DRE demonstrated a sensitivity of 82%, specificity of 32%, +likelihood ratio 1.2 (95% confidence interval (CI), 0.95-1.16) and -likelihood ratio of 0.6 (95% CI, 0.2-1.24) for detecting a complete EAS defect on endoanal US. CONCLUSION: DRE has poor specificity for detecting anal sphincter defects seen on endoanal US.
INTRODUCTION AND HYPOTHESIS: This study aims to determine the accuracy of digital rectal examination (DRE) to detect anal sphincter defects when compared to endoanal ultrasound (US) in women with fecal incontinence (FI). METHODS: Seventy-four patients identified by retrospective chart review who presented with complaints of bothersome FI who underwent endoanal US are the subjects of this analysis. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for the ability of the DRE to detect anal sphincter defects. RESULTS:Anal sphincter defect was suspected on DRE in 75%. At endoanal US, external sphincter defects were noted in all three segments in 41% (complete defect) while partial defects were noted in 30%. DRE demonstrated a sensitivity of 82%, specificity of 32%, +likelihood ratio 1.2 (95% confidence interval (CI), 0.95-1.16) and -likelihood ratio of 0.6 (95% CI, 0.2-1.24) for detecting a complete EAS defect on endoanal US. CONCLUSION: DRE has poor specificity for detecting anal sphincter defects seen on endoanal US.
Authors: Ingrid Nygaard; Matthew D Barber; Kathryn L Burgio; Kimberly Kenton; Susan Meikle; Joseph Schaffer; Cathie Spino; William E Whitehead; Jennifer Wu; Debra J Brody Journal: JAMA Date: 2008-09-17 Impact factor: 56.272
Authors: Annette C Dobben; Maaike P Terra; Marije Deutekom; Michael F Gerhards; A Bart Bijnen; Richelle J F Felt-Bersma; Lucas W M Janssen; Patrick M M Bossuyt; Jaap Stoker Journal: Int J Colorectal Dis Date: 2006-11-10 Impact factor: 2.796
Authors: Jaan Kirss; Heikki Huhtinen; Eini Niskanen; Jyrki Ruohonen; Marja Kallio-Packalen; Sarita Victorzon; Mikael Victorzon; Tarja Pinta Journal: Eur Radiol Date: 2019-03-26 Impact factor: 5.315
Authors: Dieter Nuernberg; Adrian Saftoiu; Ana Paula Barreiros; Eike Burmester; Elena Tatiana Ivan; Dirk-André Clevert; Christoph F Dietrich; Odd Helge Gilja; Torben Lorentzen; Giovanni Maconi; Ismail Mihmanli; Christian Pallson Nolsoe; Frank Pfeffer; Søren Rafael Rafaelsen; Zeno Sparchez; Peter Vilmann; Jo Erling Riise Waage Journal: Ultrasound Int Open Date: 2019-02-05