Anorectal manometry — How to perform and interpret manometry

Anorectal manometry is the most widely used technique for detecting abnormalities of sphincter function and recto-anal coordination. It enables the investigation of defaecatory difficulties, including anal incontinence and evacuatory difficulties, the assessment of patients with anal fistula and obstetric anal sphincter injury. Anorectal manometry is routinely used in combination with other tests, such as endoanal ultrasound or defaecatory imaging to understand the pathophysiology and aid treatment planning.There are various techniques and reporting protocols available but adopting standardised methods is essential for meaningful results and for comparing results between different units. This paper follows the workshop on anorectal manometry at the International Continence Society conference in Vienna in 2022. It aims to outline the various techniques and equipment available, with examples of high-resolution manometry cases and their interpretation.