AIM To prove the hypothesis that cavernosus muscles' contraction during coitus affects the reflex contraction of anal sphincters. METHODS Electromyographic response of external and internal anal sphincters to ischiocavernosus and bulbocavernosus muscle stimulation was studied in 17 healthy volunteers (10 men, 7 women, mean aged 38.3+/-11.6 years). The test was repeated after individual anesth...

AIM To evaluate the usefulness of counting nucleolar organiser region associated proteins (AgNORs) in the management of anal squamous neoplasia. METHOD Using a silver staining technique for NOR associated proteins, 32 routinely processed paraffin wax embedded sections of anal epithelium were assessed. These consisted of normal anal epithelium (n = 9), anal intraepithelial neoplasia (AIN) grad...

The association between human papillomavirus (HPV) and anal cancer and the similarities between the "transitional zones" within the cervix and anus have raised questions regarding the medical biology of anal cancer. In recent years, increased rates of HPV infection and anal cancer among men have encouraged the medical community to search for causes and ways to identify the less insidious precur...

This study is the first published assessment of the effect of anoreceptive intercourse (ARI) on anal sphincter tone and function. Forty anoreceptive (AR) male homosexuals were compared with 18 age matched non-anoreceptive (non-AR) heterosexual males. Subjects were questioned about ARI, defaecation and faecal incontinence. Anal resting pressure, maximum voluntary squeeze pressure, anal mucosal e...

Background—Topical nitrates lower anal sphincter pressure and heal anal fissures, but a majority of patients experience headache. The internal anal sphincter has a calcium dependent mechanism to maintain tone, and also receives an inhibitory extrinsic cholinergic innervation. It may therefore be possible to lower anal sphincter pressure using calcium channel blockers and cholinergic agonists wi...

This editorial describes the contents of this special issue of Sexual Health devoted to anal cancer. The aim of the issue is to provide readers with information to assist them in making decisions about what to do about detecting anal cancer early in men who have sex with men with HIV. Should they be advocating screening? It discusses the epidemiology of HPV infection, anal intraepithelial neopl...

AN ANAL FISSURE is ai1 ulcer of t h e a n a l canal which may extend from the anal verge to the dentate line. It is usually exquisitely painful, so the best treatment is that which is the most expedient but also provides negli#ble recurrence and minimal disability of anal function. Lateral subcutaneous internal anal sphincterotomy best fulfills these criteria and we strongly recommend it as the...

Human papillomavirus causes anal condylomata, high-grade anal intraepithelial neoplasia, and anal squamous cell cancer. We found high-grade intraepithelial neoplasia or squamous cell cancer in 75 (47%) of 159 HIV-seropositive men who have sex with men (MSM) and in 42 (26%) of 160 HIV-seronegative MSM with anal condylomata meriting surgery (P<.001, determined by use of the chi(2) test). Anal con...

PURPOSE OF REVIEW Persistent human papillomavirus (HPV) infection is very frequent in HIV-positive men who have sex with men. This review summarizes recent data on papillomavirus-induced anal intraepithelial neoplasia and anal cancer in these patients. Moreover, data are provided on penile and oral HPV-associated diseases, for which only limited information is available in the literature. REC...