Correlation between clinical and 3D endoanal ultrasonography image in fecal incontinent multiparous women

• Grant number: 10/17783-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: March 01, 2011
• End date: December 31, 2011
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Sergio Carlos Nahas
• Grantee: Mariane Gouvêa Monteiro de Camargo
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Fecal incontinence is a degrading condition characterized by involuntary loss of flatus, liquid or solid stool. Entails costs and inconvenience to society. One of the most common risk factors of fecal incontinence is obstetric trauma. Pregnancy and parity have demonstrated significant cause-effect relationship with fecal incontinence in several studies of world literature, considered the most common cause of fecal incontinence in young women. The three-dimensional endoanal ultrasonography (USG 3D) is an important tool in research and evaluation of these patients, providing more information about the anatomy of sphincter of patients with fecal incontinence. In Brazil, there are no studies that address this issue, which sparked interest in evaluating the influence of vaginal delivery in the development of fecal incontinence and its relationship with chronic lesions of the sphincter apparatus. This study will aim to assess the anatomic findings of 3D ultrasonography in female patients with clinical symptoms of fecal incontinence, with obstetric history (vaginal and / or caesarean section) and to correlate these findings with the severity of symptoms of patients. In addition, a parallel is made with results found in studies of other reference services, especially international. This study will be prospective and include female patients undergoing USG 3D. Clinical symptoms and severity of fecal incontinence in each patient will be evaluated by applying the incontinence score proposed by Jorge & Wexner. Sonographic examinations are performed as indicated for evaluation of anatomical abnormalities in patients with clinical complaints of fecal incontinence, as is routinely done in the service, after approval by Medical Ethics Committee of the Department of Gastroenterology HCFMUSP and obtaining written consent. Comparative analysis will be made between the clinical and imaging, searching the correlation of clinical and laboratory findings for each patient. It will also be carried out comparative analysis of the sonographic findings of each group of patients, evaluating the anatomical differences depending on the parity and the access road to the birth of each patient. Statistical analysis will rely on the help of the statistician of the Department.