AIM To assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP). METHODS In this unmatched case control study, 30 consecutive female patients with CP and 25 normal women (control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincte...

The mechanics of defecation and fecal continence are poorly understood. Valvular theories for continence 2 rely on raised intra-abdominal pressure to force the anterior wall of the rectum downwards to close off the anorectal junction. Such theories are not consistent with EMG and radiological data which suggest a striated muscle sphincteric mechanism.3 It has been demonstrated that puborectalis...

Hypothesis / aims of study Levator ani (LA) muscles which consist of the iliococcygeus, puborectalis, and pubococcygeus muscles are believed to play a significant role in the urethral support system [1]. However the relative importance of the three LA muscle components in contributing to the urethral support function remains unclear. The aim of this study is to specify the contributions of the ...

The role of pelvic floor muscle contraction in the genesis of anal canal pressure is not clear. Recent studies have suggested that vaginal distension increases pelvic floor muscle contraction. We studied the effects of vaginal distension on anal canal pressure in 15 nullipara asymptomatic women. Anal pressure, rest, and squeeze were measured using station pull-through manometry techniques with ...

CONTEXT Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. OBJECTIVE To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. ...

OBJECTIVE To develop a three-dimensional computer model to predict levator ani muscle stretch during vaginal birth. METHODS Serial magnetic resonance images from a healthy nulliparous 34-year-old woman, published anatomic data, and engineering graphics software were used to construct a structural model of the levator ani muscles along with related passive tissues. The model was used to quanti...

OBJECTIVE The objective of the study was to develop a model of the female pelvic floor to study levator stretch during simulated childbirth. STUDY DESIGN Magnetic resonance data from an asymptomatic nulligravida were segmented into pelvic muscles and bones to create a simulation model. Stiffness estimates of lateral and anteroposterior levator attachments were varied to estimate the impact on...