Endorectal ultrasound is an additional diagnostic tool used in the evaluation and management of patients with fecal incontinence. It can identify defects of the internal and external anal sphincters, helping to confirm findings that may be suggested by anorectal manometry. The examination also allows clinicians to assess the structure and integrity of the sphincter muscles and surrounding tissues.

Endorectal ultrasound requires little to no patient preparation. During the procedure, the patient is positioned in the left lateral decubitus position. A condom filled with ultrasound-conductive gel is placed over the ultrasound transducer, lubricated, and gently inserted into the anal canal. The 360-degree endorectal ultrasound examination is generally well tolerated by most patients.

The procedure produces detailed images of the anal sphincter complex and other pelvic floor structures, including the puborectalis muscle and the internal and external anal sphincters. These images can help identify sphincter defects, pelvic floor injuries, and other structural abnormalities. Images may be stored electronically, with relevant measurements and defects labeled, and incorporated into the patient’s electronic medical record for documentation and future clinical reference.