Anorectal physiology measurements and their value in perineal descent
Research type
Research Study
Full title
The anatomical anal canal vs the functional high pressure zone: the relationship between anorectal physiology measurements and their value in the diagnosis of resting perineal descent
IRAS ID
153428
Contact name
Kate Brownley
Contact email
Sponsor organisation
Leeds Teaching Hospitals NHS Trust
Duration of Study in the UK
0 years, 2 months, 28 days
Research summary
Much of the work within Gastrointestinal Physiology is concerned with the functioning of muscles within the lower gastrointestinal tract, namely the structures involved in bowel continence (the internal and external anal sphincter), of which anorectal manometry - a pressure measuring technique is the principle test. However this is an indirect measure, merely recording the pressure within the anal canal. We have made presumptions that these pressures correlate to the strength of the sphincter muscles. However, studies which have tried to link findings from manometry to specific anatomical structures (determined by endoanal ultrasound) have weak correlations.
If one were to generalise, pressure profiles (aka the functional anal canal / high pressure zone - HPZ) of the anal canal can be divided into 1) a bell-shaped broad curve or 2)a short distally placed curve. This project, through unique metholology, will aim to understand how anatomical structures within the anal canal contribute to the high pressure zone. Importantly, it will hopefully clarify whether this distally-placed pressure curve has any clinical significance in the diagnosis of resting perineal descent as compared to proctography (an x-ray examination of the lower bowel).
The study will recruit patients who are referred to the gastrointestinal physiology department at Leeds General Infirmary for anorectal physiology investigations (anorectal manometry and endoanal ultrasound). These investigations have been pre-requested by their consultants as part of their routine clinical work-up and therefore this study will not subject the patients to any additional tests, only a slight lengthening of one procedure. Similarly, there will be no additional cost issues including staffing as I am the sole investigator and this forms part of my university work. Data collection should take 12 weeks to recruit sufficient numbers of eligible patients (n=20-30). (Eligibility includes, but not limited to: female sex,scheduled for proctography, no previous anal canal surgery, no haemorrhoids, no prolapse).
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
14/YH/1299
Date of REC Opinion
12 Jan 2015
REC opinion
Further Information Favourable Opinion