Sensory and motor dysfunction assessed by anorectal manometry in uterine cervical carcinoma patients with radiation-induced late rectal complication

Gwi Eon Kim, John Jihoon Lim, Won Park, Hee Chul Park, Eun Ji Chung, Jinsil Seong, Chang-Ok Suh, Yongchan Lee, HyoJin Park

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Abstract

Purpose: To investigate the effects of radiation on anorectal function in patients with carcinoma of the uterine cervix. Methods and Materials: Anorectal manometry was carried out on 24 patients (complication group) with late radiation proctitis. All of the manometric data from these patients were compared with those from 24 agematched female volunteers (control group), in whom radiation treatment had not yet been performed. Results: Regardless of the severity of proctitis symptoms, 25% of patients demonstrated all their manometric data within the normal range, but 75% of patients exhibited one or more abnormal manometric parameters for sensory or motor functions. Six patients (25%) had an isolated sensory dysfunction, eight patients (33.3%) had an isolated motor dysfunction, and four patients (16.7%) had combined disturbances of both sensory and motor functions. The maximum tolerable volume, the minimal threshold volume, and the urgent volume in the complication group were significantly reduced compared with those in the control group. The mean squeeze pressure in the complication group was significantly reduced, whereas the mean resting pressure and anal sphincter length were unchanged. Conclusions: Physiologic changes of the anorectum in patients with late radiation proctitis seem to be caused by a variety of sensory and/or motor dysfunctions in which many different mechanisms are working together. The reduced rectal reservoir capacity and impaired sensory functions were crucial factors for functional disorder in such patients. In addition, radiation damage to the external anal sphincter muscle was considered to be an important cause of motor dysfunction.

Original languageEnglish
Pages (from-to)835-841
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume41
Issue number4
DOIs
Publication statusPublished - 1998 Jul 1

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All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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