What is the role of endoanal ultrasound in continence workups?

• A. Visualizes the external urethral sphincter.
• B. Visualizes the anal sphincter anatomy to detect defects or tears contributing to incontinence.
• C. Measures bladder pressure.
• D. Examines vaginal mucosa.

Answer: (B)

Endoanal ultrasound images the anal sphincter complex to assess its integrity and anatomy. In continence workups, this technique reveals defects or tears in the internal and external anal sphincters that can contribute to fecal incontinence, such as those from obstetric injury or previous surgery. Identifying the exact location and extent of a sphincter defect helps guide management, including surgical repair (sphincteroplasty), targeted injections, or alternative continence strategies. This imaging modality is not used to measure bladder pressure—that requires urodynamics—and it does not assess vaginal mucosa. It also focuses on the anal sphincter complex rather than the urethral sphincter.