THE EVALUATION OF DIGITAL RECTAL EXAMINATION FOR ASSESSMENT OF ANAL TONE

IntroductionCauda equina syndrome represents the constellation of symptoms and signs resulting from compression of lumbosacral nerve routes. Combined with subjective neurological findings, a reduction in anal tone is an important sign deeming further imaging necessary. Our main objective was to investigate the validity of DRE for assessment of anal tone.Method75 doctors completed a questionnaire documenting their grade, speciality and experience in performing DRE. A model anus, using a pressure transducer surrounding an artificial canal, was assembled and calibrated. Participants performed 4 DREs on the model and predicted tone as ‘reduced’ or ‘normal’ (35 and 60 mmHg respectively), followed by a ‘squeeze’ test. 30 healthcare assistants (HCAs) with no training in DRE partook as a control group.ResultsIn each attempt 60%, 61%, 63% and 72% of doctors correctly identified the anal tone respectively (average accuracy 64%). HCAs had an identical average accuracy of 64%. 100% of participants correctly felt the ...