Proctographic features of anismus

Steve Halligan, Clive I. Bartram, Hyo J. Park, Michael A. Kamm

Research output: Contribution to journalArticlepeer-review

99 Citations (Scopus)


PURPOSE: To document the proctographic features of anismus at evacuation proctography and determine the optimum radiologic measurements for diagnosis. MATERIALS AND METHODS: Twenty-four patients with anismus according to clinical and multiple physiologic criteria were examined with evacuation proctography. Structural and functional measurements were compared with those of a group of 20 asymptomatic subjects. RESULTS: No significant difference between patients and control subjects was found with respect to pelvic descent, rectocele, or any anorectal angle measurement. In patients with anismus, initiation of evacuation was prolonged (median, 9 vs 3 seconds for control subjects; P < .0001) and anal canal width was reduced (median, 0.6 vs 1.2 cm; P = .0075). Evacuation time was increased (median, 50 vs 10 seconds; P < .0001), and the percentage of contrast material evacuated was decreased (median, 60% vs 100%; P < .0001). Only four patients were able to evacuate more than 66% of the contrast material within 30 seconds, whereas all control subjects were able to do so. CONCLUSION: Measurement of the anorectal angle to diagnose anismus should be abandoned. Patients with anismus demonstrate delayed initiation of evacuation, which is also prolonged and incomplete. Incomplete evacuation after 30 seconds is highly suggestive of anismus.

Original languageEnglish
Pages (from-to)679-682
Number of pages4
Issue number3
Publication statusPublished - 1995 Dec

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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