Anorectal Manometry Versus Patient-Reported Outcome Measures as a Predictor of Maximal Treatment for Fecal Incontinence

Lisa Ramage; Shengyang Qiu; Zhu Yeap; Constantinos Simillis; Christos Kontovounisios; Paris Tekkis; Emile Tan

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저자정보: Lisa Ramage (Chelsea and Westminster Hospital) Shengyang Qiu (Chelsea and Westminster Hospital) Zhu Yeap (Chelsea and Westminster Hospital) Constantinos Simillis (Chelsea and Westminster Hospital) Christos Kontovounisios (Chelsea and Westminster Hospital) Paris Tekkis (Chelsea and Westminster Hospital) Emile Tan (Singapore General Hospital)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.35 No.6

발행연도: 2019.1

수록면: 319 - 326 (8page)

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Purpose: This study aims to establish the ability of patient-reported outcome measures (PROMs) and anorectal manometry (ARM) in predicting the need for surgery in patients with fecal incontinence (FI). Methods: Between 2008 and 2015, PROMs data, including the Birmingham Bowel and Urinary Symptoms Questionnaire (BBUSQ), Short Form 36 (SF-36), Wexner Incontinence Score and ARM results, were prospectively collected from 276 patients presenting with FI. Spearman rank was used to assess correlations between specific PROMs questions and ARM assessments of sphincter motor function. Binomial regression analyses were performed to identify factors predictive of the need for surgery. Finally, receiver operating characteristic (ROC) curve analyses were performed to establish the utility of individual ARM and PROMs variables in predicting the need for surgical intervention in patients with FI. Results: Two hundred twenty-eight patients (82.60%) were treated conservatively while 48 (17.39%) underwent surgery. On univariate analyses, all 4 domains of the BBUSQ, all 8 domains of the SF-36, and the Wexner Incontinence Score were significant predictors of surgery. Additionally, maximum resting pressure, 5-second squeeze endurance, threshold volume, and urge volume were significant. On ROC curve analyses, the only significant ARM measurement was the 5-second squeeze endurance. PROMs, such as the incontinence domain of the BBUSQ and five of the SF-36 domains, were identified as fair discriminators of the need for surgery. Conclusion: PROMs are reliable predictors of maximal treatment in patients with FI and can be readily used in primary care to aid surgical referrals and can be applied in hospital settings as an aid to guide surgical treatment decisions.

#Anorectal physiology #Anorectal manometry #Patient-reported outcome measures #Fecal incontinence

참고문헌 (14)

참고문헌 신청

Rao SS / 2004 / American College of Gastroenterology Practice Parameters Committee. Diagnosis and management of fecal incontinence. American College of Gastroenterology Practice Parameters Committee / Am J Gastroenterol 99:1585~1604

Ng KS / 2015 / Fecal incontinence : community prevalence and associated factors--a systematic review / Dis Colon Rectum 58:1194~1209

Norton C / 2007 / Management of faecal incontinence in adults : summary of NICE guidance / BMJ 334:1370~1371

Hiller L / 2002 / Development and validation of a questionnaire for the assessment of bowel and lower urinary tract symptoms in women / BJOG 109:413~423

Jorge JM / 1993 / Etiology and management of fecal incontinence / Dis Colon Rectum 36:77~97

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