AIM To evaluate the use of anorectal manometry to select patients for controlled anal dilatation. METHODOLOGY A prospective study was performed using anorectal manometry on all patients with chronic anal fissure who did not have a good response to conservative treatment. Those with increased anal resting pressure were treated with controlled anal dilatation using a two valved anuscope. A seco...

Several common anorectal diseases—fecal incontinence, complex and recurrent perianal fistulas, and rectal tumors—require imaging for proper management. Magnetic resonance imaging (MRI) has become a valuable alternative to endosonography, with superiority in several aspects of diagnosis and management. Initially, MRI with the use of a body coil and surface coil MRI were introduced. Although the ...

BACKGROUND/PURPOSE Most surgeons recommend daily dilatation after surgery for Hirschsprung disease and anorectal malformations. Our goal was to critically evaluate the potential risks and benefits of this practice. METHODS A retrospective chart review was carried out of all children undergoing repair of Hirschsprung disease or anorectal malformation over 5 years. Patients with long segment Hi...

PURPOSE For several decades, the low anterior resection (LAR) with total mesorectal excision (TME) has been the gold standard for treating patients with rectal cancer. Up to 90% of patients undergoing sphincter-preserving surgery will have changes in bowel habits, so-called 'anterior resection syndrome.' This study examined patients' continence after a LAR for the treatment of rectal cancer. ...

Infection of the anorectal area with some subtypes of HPV virus results in local involvement that appears as warty, papillary, condylomatous lesions. Patients exposed to high-risk HPV types, such as HPV-16, -18, and -31, are at risk for developing high-grade dysplasias or carcinomas. We reviewed 15 years (1991 - 2006) of patient records from our proctological unit and STD center and found 1,122...

Increased anorectal human papillomavirus (HPV) infection is related to the recent trends in sexual behavior in both homosexual and heterosexual groups and prevalence of infection with human immunodeficiency virus (HIV). Clinical presentation and natural history depend on the serotype involved. HPV 6 and 11 are found in the benign wart. Local control can be achieved with a wide selection of surg...

We report an exceedingly rare case of amelanotic anorectal melanoma misdiagnosed as hemorrhoids. A 74-year-old man presented with a week's history of "blood on toilet tissue" without bowel complaints or history of cutaneous melanoma. Skin evaluation was normal. Rectal exam was negative for blood, but revealed an anal nodule, interpreted as a hemorrhoid. Hemoglobin was normal; bleeding persisted...

One hundred and sixty nine patients with anorectal malformation were studied: there were 108 boys, 60 girls, and one case of intersex. Low malformations were more common in both sexes. Over half the subjects had associated malformations. These were more common in the group with high malformations. There was no difference between the sexes in this respect. A family history of similar malformatio...

Despite recent methodological advancement of the practical pain medicine, many cases of the chronic anorectal pain have been intractable. A 54-year-old female patient who had a month history of a constant severe anorectal pain was referred to our clinic for further management. No organic or functional pathology was found. In spite of several modalities of management, such as medications and ner...

Anorectal malformations (ARM) are associated with a myriad of congenital anomalies. The prevalence rates of associated anomalies range from 20% to 80%, commonest being urogenital anomalies. Other important associations and syndromes include Down syndrome and VACTERL (vertebral, anorectal, cardiac, trachea-esophageal, renal, limb) anomalies [1]. ARM has rarely been described in association with ...