PURPOSE: Solitary @entity1066 is a rare condition characterized by @entity32 and chronic ulcer of the rectal wall in @entity1 suffering from outlet @entity1142 . Despite similar surgical options (rectopexy, anterior resection), solitary @entity1066 may differ from overt @entity3577 with regard to symptoms and pathogenesis. The present work analyzed differences between these conditions in a case-control physiology study. METHODS: From 1997 to 2002, 931 consecutive subjects were investigated in a single physiology unit for @entity2383 . Standardized questionnaires, anorectal physiology, and evacuation proctography were included in a prospective database. Diagnosis of solitary @entity1066 was based on both symptoms and anatomic features in 25 subjects with no overt @entity3577 (21 females and 4 males; mean age, 37.2 +/- 15.7 years) and no past history of anorectal surgery. They were compared with age-matched and gender-matched subjects: 25 with outlet @entity1142 (also matched on degree of internal procidentia), 25 with overt @entity3577 without any mucosal change, and 14 with overt @entity3577 and mucosal changes. RESULTS: Subjects with solitary @entity1066 reported symptomatic levels (digitations, @entity158 , @entity322 ) similar to those of @entity1 with outlet @entity1142 , but they had significantly more @entity1142 and less @entity322 than @entity1 with overt @entity3577 . Compared with each of the three control groups ( @entity1142 , @entity3577 without mucosal change, and @entity3577 with mucosal change), subjects with solitary @entity1066 more frequently had an increasing anal pressure at strain (15 vs. 5, 3, and 1, respectively ; P < 0.01) and a paradoxical puborectalis contraction (15 vs. 9, 1, and 1, respectively; P < 0.05). With respect to evacuating proctography, complete rectal emptying was achieved less frequently in this group (5 vs. 12, 23, and 10, respectively; P < 0.05). Compared with @entity1 with overt @entity3577 , mean resting and squeezing anal pressures were significantly higher in both groups of subjects with solitary @entity1066 and with outlet @entity1142 . Prevalence and levels of @entity74 (perineal descent, rectocele) did not differ among the four groups except for @entity3577 grade and prevalence of enterocele (higher in overt @entity3577 group). Interestingly, and despite matched controls for degree of intussusception, individuals with solitary @entity1066 had circular internal procidentia more often compared with those suffering from outlet @entity1142 without @entity3137 (15 vs. 8, P < 0.05). CONCLUSION: This case-controlled study quantifies functional @entity74 in @entity1 suffering from solitary @entity1066 . Despite no proven etiologic factor, @entity1690 and circular internal procidentia both may play an important part in the pathogenesis and an exclusive surgical approach may not be appropriate in this context.

Anorectal physiology in solitary XXXX : a case-matched series.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity1690 :: ('MESH:D046628', 'Disease') :: ['sphincter-obstructed defecation'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer syndrome'] @entity74 :: ('MESH:D030342', 'Disease') :: ['anal disorders', 'anatomic disorders'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity1142 :: ('MESH:D003248', 'Disease') :: ['dyschezia', 'constipation'] @entity3577 :: ('MESH:D056887', 'Disease') :: ['rectal prolapse'] @entity3137 :: ('MESH:D009059', 'Disease') :: ['mucosal lesions'] @entity2383 :: ('MESH:D028361', 'Disease') :: ['anorectal functional disorders']
@entity1066 :: (MESH:D014456,Disease) :: ['ulcer syndrome']
