Clinical Use of Two-Dimensional Endoanal and Transvaginal Sonography

Endoanal ultrasonography has an established place in benign proctological practice, specifically in the assessment of external and internal anal sphincter defects in patients presenting with fecal incontinence, in perirectal sepsis, (either of cryptogenic or other origin) and in some patients presenting with evacuatory difficulty where extrarectal lesions resulting in mechanical block are demonstrated [1-5]. It may also prove useful in specialized conditions referred to a proctology clinic, including paradoxical puborectalis contraction (anismus), solitary rectal ulcer syndrome and rectal prolapse, as well as in difficult cases of persistent proctalgia. Specific examples of its use in a tertiary referral practice are shown below with all patients being assessed (unless otherwise stated) in the Sims left lateral position* utilizing a 7.5 MHz endoanal probe (BK, Copenhagen DK).