. 2022 Nov 9;29(11):1819–1825. doi: 10.1093/ibd/izac234

Table 1.

Studies utilizing APM to assess for dyssynergic defecation in patients with IPAA.

Author and Year [Reference]	No. Patients	Pattern of APM Abnormality	Balloon Expulsion Test	MRI or Barium Defecography	Risk of Bias^b	Quality Assessment^c
Hull et al. (1993)¹⁰	n = 6	6/6 (10.00%) paradoxical puborectalis contraction on EMG	NA	NA	High risk	Poor
Khanna et al. (2013)¹¹	n = 35 with inflammatory/structural pouch disorder	6/35 (17.1%) paradoxical contraction on APM	7/35 (20.0%) failed BET	6/35 (20.7%) paradoxical	Some concerns	Fair
Khanna et al. (2013)¹¹	n = 10 with functional pouch disorder	5/10 (50.0%) paradoxical contraction on APM	6/10 (60.0%) failed BET	5/10 (50.0%) paradoxical	Some concerns	Fair
Quinn et al. (2017)¹²	n = 66 with chronic pouchitis	55/66 (83.3%) nonrelaxing pelvic floor disorder^a on APM	43/55 (78.2%) failed BET	14/55 (25.5%) abnormal	Some concerns	Good
Quinn et al. (2017)¹²	n = 45 without chronic pouchitis	28/45 (62.2%) non relaxing pelvic floor disorder on APM	22/28 (78.6%) failed BET	7/28 (25.0%) abnormal	Some concerns	Good
The Mount Sinai Experience (2022)⁷	n = 10 with inflammatory/structural pouch disorder	4/10 (40.0%) paradoxical contraction on APM	3/3 (100.0%) failed BET	1/2 (50.0%) abnormal	N/A	N/A
The Mount Sinai Experience (2022)⁷	n = 7 with functional pouch disorder	4/7 (57.1%) paradoxical contraction on APM	3/6 (50.0%) failed BET	2/6 (33.3%) abnormal	N/A	N/A

Abbreviations: APM, anopouch manometry; BET, balloon expulsion test; EMG, electromyography; IPAA, ileo-anal pouch anastomosis.

^aNonrelaxing pelvic floor disorder defined in text.

^bROBINS-E Risk of Bias.

^cNIH Quality Assessment Tool for Case Series Study.