PURPOSE: This study was designed to determine whether anorectal physiology testing significantly altered @entity1 management in the setting of @entity1241 . METHODS: @entity1 referred to the anorectal physiology laboratory for evaluation of @entity1241 were prospectively interviewed and examined by a colon and rectal surgeon. A decision to treat either medically or surgically was reached. The @entity1 underwent physiologic testing with transanal ultrasound, pudendal nerve terminal motor latency, and anorectal manometry. A panel of board-certified colon and rectal surgeons then reviewed the history and physical examination, as well as the anorectal physiology tests, of each @entity1 and reached a consensus on management. Management plans before and after physiologic evaluation were compared. RESULTS: Ninety @entity1 (6 males) were entered into the study. The @entity1 were divided in two groups: those with pretest medical management plans (n = 45) and those with pretest surgical management plans (n = 45). A change in management was noted in nine @entity1 (10 percent). In the medical management group, the management changed from medical to surgical therapy in five @entity1 . Transanal ultrasound detected anal sphincter defects in all @entity1 who changed from medical to surgical management but in only 10 percent of those who remained under medical management (P = 0.0001). In the surgical management group, three @entity1 (7 percent) changed from surgical to medical therapy and one @entity1 (2 percent) changed from sphincteroplasty to neosphincter. Transanal ultrasound detected a limited anal sphincter defect in one @entity1 (33 percent) who changed from surgical to medical management and a significant defect in all 41 @entity1 (100 percent) who remained under surgical management (P = 0.003). CONCLUSIONS: Anorectal physiology testing is useful in the evaluation of @entity1 with @entity1241 . Without the information obtained from physiologic testing, 11 percent of @entity1 who may have benefited from surgery would not have been given this option, and 7 percent of @entity1 could have potentially undergone unnecessary surgery. Transanal ultrasound is the study most likely to change a @entity1 's management plan.

A prospective evaluation of the value of anorectal physiology in the management of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patients'] @entity1241 :: ('MESH:D005242', 'Disease') :: ['fecal incontinence']
@entity1241 :: (MESH:D005242,Disease) :: ['fecal incontinence']
