Endoanal ultrasound findings in patients with faecal incontinence using a scoring system

Introduction
The main aim of the study was to apply a severity classification of sphincter lesions detected by endoanal ultrasound using Starck score in patients who suffered faecal incontinence.

Material and method
Data were analysed on 133 patients with faecal incontinence. Those in whom anal sphincter lesions were detected by endoanal ultrasound are described and their corresponding scores according to Starck classification calculated. This system scores severity of detected sphincter lesions from 0 to 16, involving the three axes of the anal canal. Patient demographic characteristics and anorectal manometry results were also analysed. The relationship between this score, patient gender and age, and anorectal manometric results were also analysed.

Results
A total of 83 (62.4%) patients had some type of anal sphincter lesion. The presence of sphincter defects was not related to gender (P=.172), although it did correlate with younger ages (P=.028). The severity of anal sphincter damage by Starck score did not show significant correlation to gender (P=.327) or to the age (P=.350) of patients. However, a significant correlation was detected between Starck score and anal resting pressure (P=.008) or anorectal squeeze pressure (P=.011).

Conclusions
The presence of anal sphincter injuries could be well defined by Starck score in patients with faecal incontinence. Severity of damage scored by Starck correlated with anorectal manometric results.