Which functional diagnostic tools do German coloproctologists favour?]

Aim: We tried to evaluate the role of anorectal functional diagnostic tools according to the judgement of German coloproctologists. Method: Questionnaires concerning accuracy of different diagnostic tests were sent to 585 physicians specialized in coloproctology. Results: 261 (44.6%) completed forms were returned. An analysis of the answers revealed that endorectal sonography is widely (73%) regarded as useful and reliable diagnostic tool. Though manometry is still frequently used, only 50.5% of the coloproctologists made their decision concerning the further treatment depending on the results of this method. Other radiologic methods as defecography and colon transit time are still regularly performed, though video-defecography is not accepted by most coloproctologists. Neurological investigations as pudendal nerve terminal latency, surface-EMG and needle-EMG are exclusively applied in specialized departments. Discussion: Regarding the variety of diagnostic tools and its different appraisal a consensus should be defined. The usefulness of neurological examination techniques needs to be clarified before their performance can be recommended for a wide-spread routine work up.