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Investigations include anorectal manometry, anorectal sensory testing, pudendal nerve terminal motor latencies (PNTML), and endoanal sonography. The severity of FI and results of investigations are often discordant and\u00a0the\u00a0rate of symptom resolution following treatment remains &lt;40%. High\u2010resolution anorectal manometry (HRAM) and three\u2010dimensional endoanal ultrasound (3D\u2010US) have been introduced during the last decade.\u00a0This study aims to assess the strength of relationships between contemporary investigation results and FI severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adults presenting for investigation of FI were assessed using the St Mark\u2019s FI severity score (SMIS),\u00a0HRAM, anorectal sensory testing, PNTML, and 3D\u2010US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>246 patients were included.\u00a0There were significant relationships between the SMIS and\u00a0HRAM (resting pressure <jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic> = \u22120.23, 95% CI = (\u22120.34, \u22120.11), <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001; squeeze pressure (<jats:italic>r<jats:sub>s<\/jats:sub>\u00a0<\/jats:italic>= \u22120.26, 95% CI = (\u22120.37, \u22120.14), <jats:italic>P<\/jats:italic>\u00a0&lt; .001) and 3D\u2010US (anterior EAS length <jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic> = \u22120.22, 95% CI = (\u22120.34, \u22120.09), <jats:italic>P<\/jats:italic>\u00a0= .001). The relationships between SMIS and HRAM had a greater effect size in those with urge\u2010predominant symptoms (resting pressure: <jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic> = \u22120.40, 95% CI = (\u22120.57, \u22120.20), <jats:italic>P<\/jats:italic>\u00a0&lt; .001, squeeze pressure: <jats:italic>r<jats:sub>s<\/jats:sub><\/jats:italic> = \u22120.34, 95% CI = (\u22120.52, \u22120.12), <jats:italic>P<\/jats:italic>\u00a0= .003).\u00a0Overall, the variance in SMIS accounted for by anorectal investigations was 8.6% (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.098, adjusted <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> = 0.086, <jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Anorectal investigations are not strong predictors of FI severity. These findings may reflect the multifactorial, heterogeneous pathophysiology of FI, the limitations of the SMIS and anorectal investigations, and contributing factors extrinsic to the anorectum.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13946","type":"journal-article","created":{"date-parts":[[2020,7,19]],"date-time":"2020-07-19T23:24:28Z","timestamp":1595201068000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The relationships between the results of contemporary tests of anorectal structure and sensorimotor function and the severity of fecal incontinence"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-2762","authenticated-orcid":false,"given":"Paul T.","family":"Heitmann","sequence":"first","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide SA Australia"},{"name":"Departments of Surgery and Gastroenterology Flinders Medical Centre  Bedford Park SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa","family":"Rabbitt","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Gastroenterology Flinders Medical Centre  Bedford Park SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann C.","family":"Schloithe","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Wattchow","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide SA Australia"},{"name":"Departments of Surgery and Gastroenterology Flinders Medical Centre  Bedford Park SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7997-1533","authenticated-orcid":false,"given":"S. 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