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Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence

AIM: Manometry is the best established technique to assess anorectal function in faecal incontinence. By systematic review, pooled prevalences of anal hypotonia/hypocontractility and rectal hypersensitivity/hyposensitivity in male and female patients were determined in controlled studies using anore...

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Autores principales: Rasijeff, Annika M. P., García‐Zermeño, Karla, Di Tanna, Gian‐Luca, Remes‐Troche, José, Knowles, Charles H., Scott, Mark S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303800/
https://www.ncbi.nlm.nih.gov/pubmed/35023242
http://dx.doi.org/10.1111/codi.16047
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author Rasijeff, Annika M. P.
García‐Zermeño, Karla
Di Tanna, Gian‐Luca
Remes‐Troche, José
Knowles, Charles H.
Scott, Mark S.
author_facet Rasijeff, Annika M. P.
García‐Zermeño, Karla
Di Tanna, Gian‐Luca
Remes‐Troche, José
Knowles, Charles H.
Scott, Mark S.
author_sort Rasijeff, Annika M. P.
collection PubMed
description AIM: Manometry is the best established technique to assess anorectal function in faecal incontinence. By systematic review, pooled prevalences of anal hypotonia/hypocontractility and rectal hypersensitivity/hyposensitivity in male and female patients were determined in controlled studies using anorectal manometry. METHODS: Searches of MEDLINE and Embase were completed. Screening, data extraction and bias assessment were performed by two reviewers. Meta‐analysis was performed based on a random effects model with heterogeneity evaluated by I (2). RESULTS: Of 2116 identified records, only 13 studies (2981 faecal incontinence patients; 1028 controls) met the inclusion criteria. Anal tone was evaluated in 10 studies and contractility in 11; rectal sensitivity in five. Only three studies had low risk of bias. Pooled prevalence of anal hypotonia was 44% (95% CI 32–56, I (2) = 96.35%) in women and 27% (95% CI 14–40, I (2) = 94.12%) in men. The pooled prevalence of anal hypocontractility was 69% (95% CI 57–81; I (2) = 98.17%) in women and 36% (95% CI 18–53; I (2) = 96.77%) in men. Pooled prevalence of rectal hypersensitivity was 10% (95% CI 4–15; I (2) = 80.09%) in women and 4% (95% CI 1–7; I (2) = 51.25%) in men, whereas hyposensitivity had a pooled prevalence of 7% (95% CI 5–9; I(2) = 0.00%) in women compared to 19% (95% CI 15–23; I (2) = 0.00%) in men. CONCLUSIONS: The number of appropriately controlled studies of anorectal manometry is small with fewer still at low risk of bias. Results were subject to gender differences, wide confidence intervals and high heterogeneity indicating the need for international collective effort to harmonize practice and reporting to improve certainty of diagnosis.
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spelling pubmed-93038002022-07-28 Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence Rasijeff, Annika M. P. García‐Zermeño, Karla Di Tanna, Gian‐Luca Remes‐Troche, José Knowles, Charles H. Scott, Mark S. Colorectal Dis Systematic Review AIM: Manometry is the best established technique to assess anorectal function in faecal incontinence. By systematic review, pooled prevalences of anal hypotonia/hypocontractility and rectal hypersensitivity/hyposensitivity in male and female patients were determined in controlled studies using anorectal manometry. METHODS: Searches of MEDLINE and Embase were completed. Screening, data extraction and bias assessment were performed by two reviewers. Meta‐analysis was performed based on a random effects model with heterogeneity evaluated by I (2). RESULTS: Of 2116 identified records, only 13 studies (2981 faecal incontinence patients; 1028 controls) met the inclusion criteria. Anal tone was evaluated in 10 studies and contractility in 11; rectal sensitivity in five. Only three studies had low risk of bias. Pooled prevalence of anal hypotonia was 44% (95% CI 32–56, I (2) = 96.35%) in women and 27% (95% CI 14–40, I (2) = 94.12%) in men. The pooled prevalence of anal hypocontractility was 69% (95% CI 57–81; I (2) = 98.17%) in women and 36% (95% CI 18–53; I (2) = 96.77%) in men. Pooled prevalence of rectal hypersensitivity was 10% (95% CI 4–15; I (2) = 80.09%) in women and 4% (95% CI 1–7; I (2) = 51.25%) in men, whereas hyposensitivity had a pooled prevalence of 7% (95% CI 5–9; I(2) = 0.00%) in women compared to 19% (95% CI 15–23; I (2) = 0.00%) in men. CONCLUSIONS: The number of appropriately controlled studies of anorectal manometry is small with fewer still at low risk of bias. Results were subject to gender differences, wide confidence intervals and high heterogeneity indicating the need for international collective effort to harmonize practice and reporting to improve certainty of diagnosis. John Wiley and Sons Inc. 2022-01-30 2022-05 /pmc/articles/PMC9303800/ /pubmed/35023242 http://dx.doi.org/10.1111/codi.16047 Text en © 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Systematic Review
Rasijeff, Annika M. P.
García‐Zermeño, Karla
Di Tanna, Gian‐Luca
Remes‐Troche, José
Knowles, Charles H.
Scott, Mark S.
Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title_full Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title_fullStr Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title_full_unstemmed Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title_short Systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
title_sort systematic review and meta‐analysis of anal motor and rectal sensory dysfunction in male and female patients undergoing anorectal manometry for symptoms of faecal incontinence
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303800/
https://www.ncbi.nlm.nih.gov/pubmed/35023242
http://dx.doi.org/10.1111/codi.16047
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