Assesment Of The Anal Sphıncter Muscle Morphology In Patıents Wıth Hemorrhoıdal Dısease By Three Dımensıonal Endoanal Ultrasonography

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Yılmaz N. , Köse E. , Ateş M. , Kavaklı A., Özbağ D.

2nd International Congress on Sports, Anthropology, Nutrition, Anatomy and Radiology, Nevşehir, Türkiye, 20 - 23 Temmuz 2020, ss.420-421

  • Basıldığı Şehir: Nevşehir
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.420-421


Introduction: In this study, it was aimed to examine the relationship between external/internal
anal sphincter muscle which are surrounding the anal canal, puborectal muscle thickness and
anal triangle area with stage IV hemorrhoidal disease and healthy individuals. At the same time,
the relationship between the muscle structure around the anal canal and anal triangle area were
examined according to the somatotype differences of all individuals included in the study.
Methods: A total of 151 volunteers, including 76 individuals diagnosed with stage IV
hemorrhoidal disease and 75 healthy (control) individuals aged 18-65, were included in the
study. The external/internal anal sphincter muscle and puborectal muscle thicknesses of all
individuals were measured by three-dimesional endoanal ultrasonography (3D-EAUSG).
Internal and external anal sphincter muscle thicknesses were measured in four quadrants (right,
left, anterior, posterior) at the level of the middle anal canal and the mean value of these
measurements was taken. Puborectal muscle thickness was measured in two quadrants (right
and left) at the upper side of anal canal and the average of these two measurements was taken.
Anal triangle dimensions of individuals in both groups were measured using digital calipers.
Anthropometric measurements of individuals were taken in accordance with the technique
proposed by the International Biological Program (IBP).
Results: It was observed that external anal sphincter muscle thickness was thicker in the patient
group than in the control group in the right and posterior quadrants (p=0,046, 0,017
respectively). Internal anal sphincter muscle thickness was found to be thicker in patient group
in the right and anterior quadrants (p=0,041, 0,006 respectively). When the muscle thickness
and anal triangle area are compared to according to the somatotype characteristics of the all
individuals, a statistically significant difference was found in external anal sphincter muscle
thickness in terms of right and posterior quadrants and mean value (p=0,012; 0,035; 0,009
respectively). A statistically significant difference was found in the mean value of
measurements taken in the right, anterior and posterior quadrants and four quadrants in internal
anal sphincter muscle thickness (p=0,036; 0,007; 0,001; 0,004 respectively). A statistically
significant difference was found between the groups in terms of anal triangle area (p=0,010).
Conclusion: In conclusion, although the anal sphincter muscle thickness of the individuals in
the patient group increased in some quadrants of the anal canal, there was no statistically
significant difference between the two groups in terms of mean values.Therefore, it is thought
that this change in the morphological structure of the anal sphincter muscles is not related to
hemorrhoidal disease.

This project was supported by İnönü University Scientific Projects Coordination Unit with the
project number of TDK-2019-1737.
Keywords: Hemorrhoidal disease, anal sphincter, anal triangle, 3D-endoanal USG,