With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment. Explores all the lastest techniques and treatments in the field Organized into two, easy to manage, sections First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders

Foreword 1 Anorectal anatomy : the contribution of new technology 3 2 Anorectal physiology 17 2.1 History, clinical examination and basic physiology 18 2.2 Rectoanal inhibition 39 2.3 Vectorvolume manometry 48 2.4 Clinical rectal compliance measurement 63 2.5(i) Impedance planimetry : application for studies of rectal function 72 2.5(ii) Impedance planimetry : clinical impedance planimetry 105 2.6 Ambulatory manometry 114 2.7 The use of colonic motility and transit studies 120 2.8 Anorectal sensitivity 137 2.9 Neurophysiology in pelvic floor disorders 153 3 Anorectal imaging 170 3.1(i) Evacuation proctography 171 3.1(ii) Defecography : a Swedish perspective 199 3.2(i) Ultrasound in coloproctologic practice : endorectal/endoanal ultrasound 217 3.2(ii) Ultrasound in coloproctologic practice : dynamic transperineal ultrasound and transvaginal sonography 246 3.2(iii) Three-dimensional endoanal ultrasound in proctological practice 263 3.3(i) MRI in colorectal surgery : surface magnetic resonance imaging in anorectal practice 275 3.3(ii) MRI in colorectal surgery : endoluminal MR imaging of anorectal diseases 298 3.3(iii) MRI in colorectal surgery : dynamic magnetic resonance imaging 322 4 Sphincter pharmacology and pharmacotherapy 351 5 Anal and perianal pathology 370 5.1 Anal histopathology 371 5.2 Anal intraepithelial neoplasia (AIN) 389 6 Assessment of the constipated patient 411 6.1 An overview 412 6.2 Managing slow-transit constipation 429 6.3 Rectocele 446 6.4 Anismus 461 6.5 Biofeedback for constipation and fecal incontinence 494 6.6 Evacuatory dysfunction following gynecologic surgery 532 7 Assessing the patient with fecal incontinence 546 7.1 An overview 547 7.2 Quality of life issues 595 7.3 Fecal and urinary incontinence : epidemiology and etiology 606 7.4 Sacral neuromodulation 620 8 Urogynecological assessment and perspective in patients presenting with evacuatory dysfunction 636 9 Assessing the postoperative patient with evacuatory dysfunction 654 9.1 Disordered defecation of the neorectum and neorectal reservoir 655 9.2 Evaluation and management of postoperative fecal incontinence 670 10 Postoperative assessment of the neosphincter 693 10.1 An overview 694 10.2 Managing functional problems following dynamic graciloplasty 706 10.3 Assessing the functional results of the artificial bowel sphincter 714 11 Functional problems in the patient with a neurological disorder 725 12 Psychological assessment of patients with proctological disorders 747 13 A practical guide to running an anorectal laboratory 761 14 Medicolegal aspects of coloproctologic practice 767