Table 2.
Comparison of HRAM outcomes between the IPAA-FI, IPAA-no-FI, and non-IBD-FI cohorts.
| IPAA-FI (n = 26) | IPAA-no-FI (n = 26) | P valuea | Non-IBD-FI (n = 84) | P valueb | |
|---|---|---|---|---|---|
| RAIRc | 6/21 (29%) | 6/24 (25%) | 1.00 | 69/70 (99%) | <.001*** |
| Sphincter length (cm) | 2.6 ± 1.0 | 3.0 ± 0.9 | .12 | 3.1 ± 0.7 | .012* |
| Resting pressure (mmHg) | 60.9 ± 36.1 | 84.3 ± 32.1 | .017* | 54.3 ± 23.0 | .39 |
| Max squeeze pressure (mmHg) | 156.2 ± 52.3 | 200.3 ± 71.1 | .014* | 153.7 ± 85.3 | .86 |
| Sustained squeeze pressure (mmHg) | 92.9 ± 35.2 | 118.5 ± 43.4 | .023* | 84.8 ± 45.7 | .41 |
| Rectal pressure, cough (mmHg) | 44.4 ± 20.4 | 60.9 ± 29.2 | .024* | 66.8 ± 25.5 | <.001*** |
| Anal pressure, cough (mmHg) | 125.4 ± 51.9 | 172.0 ± 72.7 | .012* | 126.0 ± 63.7 | .97 |
| Recto-anal pressure gradient, cough (mmHg) | −81.0 ± 48.8 | −113.6 ± 63.9 | .046* | −59.2 ± 53.2 | .07 |
| Rectal pressure, push (mmHg) | 37.5 ± 22.7 | 39.4 ± 25.3 | .77 | 46.4 ± 21.1 | .07 |
| Anal residual pressure, push (mmHg) | 62.5 ± 31.7 | 73.7 ± 31.8 | .21 | 65.0 ± 41.5 | .78 |
| First sensation (cc) | 40.0 ± 44.8 | 46.4 ± 53.8 | .65 | 22.8 ± 23.1 | .07 |
| Constant sensation (cc) | 57.7 ± 47.7 | 65.6 ± 61.7 | .61 | 36.4 ± 34.0 | .014* |
| Desire to defecate (cc) | 92.3 ± 65.2 | 125.0 ± 91.2 | .16 | 86.0 ± 62.9 | .66 |
| Urge to defecate (cc) | 128.1 ± 72.6 | 173.5 ± 93.0 | .06 | 130.6 ± 69.8 | .87 |
| Max tolerable volume (cc) | 175.4 ± 83.9 | 217.5 ± 89.0 | .09 | 174.3 ± 72.0 | .95 |
| BETd | 0/18 (0%) | 2/15 (13%) | 53/82 (65%) | ||
| Defecatory disorders on HRAMe | 22/26 (84%) | 14/26 (54%) | .034* | 63/84 (75%) | .42 |
Abbreviations: BET, balloon expulsion test; FI, fecal incontinence; HRAM, high-resolution anorectal manometry; IBD, inflammatory bowel disease; IPAA, ileal pouch–anal anastomosis; RAIR, recto-anal inhibitory reflex.
*denotes statistical significance (P < .05); **denotes statistical significance (P < .01); ***denotes statistical significance (P < .001).
a P value comparing the IPAA-FI cohort to the IPAA-no-FI cohort.
b P value comparing the IPAA-FI cohort to the non-IBD-FI cohort.
cRAIR = recto-anal inhibitory reflex. RAIR was unable to be assessed in 5 IPAA-FI patients, 2 IPAA-no-FI patients, and 14 non-IBD-FI patients.
dBET assesses the ability of a patient to expulse the balloon catheter within 1 minute. BET was not assessed in 8 IPAA-FI patients, 11 IPAA-no-FI patients, and 2 non-IBD-FI patients.
eDefecatory disorders include dyssynergia (specifically paradoxical contraction), poor propulsive force, and inadequate anal sphincter relaxation during the push maneuver on HRAM.
Bolded text denotes analyses found to be statistically significant (P < .05).