{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T03:05:14Z","timestamp":1776395114166,"version":"3.51.2"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,19]],"date-time":"2023-02-19T00:00:00Z","timestamp":1676764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Treatment outcomes for accidental bowel leakage (ABL) may be influenced by age\u2010related sarcopenia. We sought to determine if thickness of the anal sphincter complex on endoanal ultrasound correlated with function in women and men with ABL and if women demonstrated age\u2010related anal sphincter thinning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with ABL presenting to our pelvic floor clinic from 2012 to 2017 were included. Clinical data were obtained from medical records. External anal sphincter (EAS), imaged by endoanal ultrasound at proximal, mid and distal locations, and IAS thickness were measured at 12, 3, 6, and 9 o'clock; puborectalis\u00a0muscle\u00a0(PRM) was measured at 4, 6, and 8 o'clock; and averaged. Anorectal manometry was conducted when clinically indicated. Data were compared using Mann\u2013Whitney tests and linear regression. Results are reported as mean\u2009\u00b1\u2009SD or median (IQR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women (<jats:italic>n<\/jats:italic>\u2009=\u2009136) were younger than men (<jats:italic>n<\/jats:italic>\u2009=\u200926) (61\u2009\u00b1\u200913\u00a0vs. 67\u2009\u00b1\u200913 years, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). More women than men had pelvic surgery and less had colorectal surgery, spinal disorders, or a history of smoking (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Eighty\u2010two percentage\u00a0of women had an anal sphincter defect versus 31% of men (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). All anal sphincter complex components were thinner in women than men with lower squeeze and resting pressures (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.03), even in nulliparous women. Mean resting pressure was lower in older 6.1 (4.6\u20137.8) versus\u00a0younger women 8.3 (5.0\u201312.9) mmHg, <jats:italic>p<\/jats:italic>\u2009=\u20090.04.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women, even nulliparous, with ABL demonstrate thinner and weaker anal sphincters than men, Aging correlated with an increase in anal sphincter thickness, suggesting that age\u2010related changes in the intrinsic components of the anal sphincter complex associated with ABL are complex and are not always well demonstrated on endoanal ultrasound.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25151","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T07:29:59Z","timestamp":1676878199000},"page":"751-760","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of sex and aging on radiographic and functional parameters of the anal sphincter complex in patients with accidental bowel leakage"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-9221","authenticated-orcid":false,"given":"Amanda M.","family":"Artsen","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences University of California San Diego  San Diego California USA"},{"name":"Magee\u2010Womens Research Institute University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisha Y.","family":"Dyer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaiser Permanente  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan R.","family":"Routzong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery University of California San Diego  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisselle","family":"Zazueta\u2010Damian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaiser Permanente  San Diego California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milena M.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Massachusetts General Hospital Harvard SOM  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Alperin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Female Pelvic Medicine and Reconstructive Surgery University of California San Diego  San Diego California 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