A prospective comparison of anoscopy and fiberendoscopy in detecting anal lesions.

With the increase in rectal and perianal disease, thorough examination of this area is necessary in every patient with colorectal complaints. We compared the current fibersigmoidoscope and colonoscope with routine anoscopy in the detection rate of perianal pathology in 115 consecutive patients. Straight withdrawal and retroflexion in the rectum of the fiberoptic instruments led to lesion detection rates of 78% and 54%, respectively. The anoscope showed 99% of lesions. Anoscopy was easily learned and required less than a minute to perform. We conclude that anoscopy should be performed in every patient undergoing fibersigmoidoscopy or colonoscopy. Instructions in this procedure should be provided in all training programs.