Measurement of the Anal Sphincter Strength by a Simple Method Suitable for Routine Use

Abstract

By determination of the ability of the anal sphincter to retain a metal ball, a simple method for routine measurement of the anal sphincter strength has been worked out. The sphincter strength was defined as the force, expressed in grammes, necessary to pull the metal ball through the anal sphincter. The lowest value recorded in a group of normals was 450 g (males 600 g, females 450 g). As the maximum value observed in a group of patients with anal incontinence was 175 g, a clear discrimination between normal and incompetent anal function was obtained. In 9 patients with preserved rectum after a previous subtotal colectomy, 8 had values within the normal range. One fell below the lowest value for normals, predicting anal incompetence after ileoproctostomy.

Key-words:

• Colectomy
• Crohn's disease
• fecal incontinence
• rectal diseases
• ulcerative colitis