Clinical Research Of Anorectal Manometry In Unrelaxed Pelvic Floor Syndrome

Chronic functional constipation is a common and frequent disease.According to the etiological factor,it can be classified to 3 types:slow transmit constipation, outlet obstruction constipation and mixed constipation.In the exitus obstruction type, Unrelaxed Pelvic Floor Syndrome(UPFS) is the common type.UPFS is a pelvic floor disease,and the paradoxical contraction of the sphincter ani externus and puborectal muscle is the cause as defecating.Recently,anorectal manometry and derivative ways had been widely applied in the diagnose and treatment for UPFS,and it had been widely admitted.It can be used in the diagnose and investigation of the anorectal disease because it is an effective quantitative test mean.It can offer much essential physiological information about colon,rectum,pelvic floor,exterior and interior sphincter so as to raise the level of the investigation,diagnose and treatment in anorectal diseases,with the colon transmission functional examination,defecography, pelvic floor electromyologram examination.I had collected 57 UPFS patients for the UPFS group from Jan 2006 to Aug 2007 in hospital,and 30 patients without the symptom of defecation functional disorder during the corresponding time for the control group.I will investigate the diagnose and treatment to UPFS on the basis of learning the external and internal pertinent literature and our comprehension.1.Abstract Objective:To raise the level of the diagnose and choose the best treatment for the patients with Unrelaxed Pelvic Floor Syndrome(UPFS),with observing the anorectal pressure changes,and understanding the changes of the pelvic floor functional pathologic physiology.2.Methods:Of the 57 patients for the UPFS group,who had a definite diagnosis of UPFS through the defecography examination,and without the general disease (DM,etc),from Jan 2006 to Aug 2007,16 cases were male,41 cases were female, whose age was from 17 to 77 years old,and the average age was 49.74±16.74 years old.The course of disease was 6 months to 40 years,and the average time of the course was 4 years.Relatively,30 healthy controls were another group.Obtain the parameters firstly,deploy the SPSS14.0 package to take the statistics analysis,then make t analysis to two group independent sample datas,and it has statistics meaning. When the P＜0.05.3.Results:To compare the two groups,the anal resting pressure in UPFS group was almost same like that in the control group(P＞0.05),the difference of the maximum anal canal contractive pressure had the significant meaning(P＜0.01),the difference of anorectal pressure when straining to defecate in UPFS group was negative and lower than that in the control group(P＜0.01).The anorectal volume and the maximum volume to incipient rectal sensation and awareness of defecation in UPFS group were larger than those in the control group(P＜0.01).It had the very significant meaning.4.Conelusions:The patients with UPFS have weak rectal sensation and pelvic floor muscle dysfunction.It is a disease of the pelvic floor muscles paradoxical contraction caused by the unrelaxed muscles.In clinical practice,operation should not be accepted firstly to the patients with UPFS,and the indication should be strictly controled.Biofeedback therapy should be the first choice so as to receive the regular reflection.But to the patients with obvious myohypertrophia,significant anal canal prolongation,ineffective conservative therapy,we can perform operation.