Algorithm of investigation of disorders of the rectum obturator apparatus in functional incompetence of anal sphincter

Aim of investigation. Assessment of algorithm of physiological methods of investigation to reveal basic pathogenic mechanisms of the functional incompetence of anal pulp sphincter.

Material and methods. Original study is based on data of the functional studies of 125 patients without organic changes of muscular structures of rectum obturator apparatus (ROA), investigated in SSC of coloproctology within 2001–2008. Interferential and segmentary electromyography (EMG), anorectal manometry, sphincterometry, profilometry, study of reservoir function of the rectum were applied.

Results. Basic types of ROA disorders at the functional failure of anal sphincter include: 1) decrease of contractile capacity of muscles of external sphincter and its refectory regulation at the background of decrease of tension of internal sphincter which can be combined to disorder of its reflex activity, 2) isolated disorder of the functional state of internal sphincter, 3) disorder of reservoir function of the rectum.

Conclusions. In pathogenesis of the functional failure disorder of anal component of continence prevails (76,0% of cases) over disorders of intestinal component (24,0%). The algorithm of the functional studies of obturator apparatus includes: EMG, profilometry, anorectal manometry, study of reservoir function of the rectum.

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