A new balloon-retaining test for evaluation of anorectal function in incontinent patients.

The balloon-retaining test consists of progressive filling of a compliant intrarectal balloon in a patient in the sitting position. The pressure inside the balloon is monitored and the patient is asked to retain the balloon as long as possible and to report first, constant, and maximal tolerable sensation levels. A balloon is used to simulate semisolid and solid stool. This test is a more realistic approach to the evaluation of fecal continence than the rectal saline infusion test and anal manometry. The test evaluates the rectal reservoir function, sensation, and sphincter competence simultaneously; however, the real rectal distensibility and compliance must be determined by compliance measurement until the maximal tolerable level for patients in a reclining position is reached. This test also permits objective evaluation of the effect of different treatments in incontinent patients.