Rectoscopy and anoscopy tests: what they are and what they involve
Rectoscopy and anoscopy are tests used to diagnose various diseases of the anal area and of the lower rectum. Where there are no specific problems, these tests are an integral part of a colorectal examination.
Special instruments called anoscopes and rectoscopes are used to carry out the tests: the physician lubricates them and then gently inserts them into the anus.
Once the desired depth is reached, the physician moves the device around with gentle circular movement to have a full view of the anal canal and of the walls of the lower rectum.
Through anoscopy or rectoscopy, the specialist can diagnose various diseases such as haemorrhoids, anal or rectal polyps, anal fistulas, condylomas and anal fissures and distal tumors.
Other instruments can also be inserted into the device: for example, if a biopsy is required or tissue samples are to be tested. During the examination, it is also possible to carry out minor procedures, such as the removal of condylomas or anal polyps.
Rectoscopy and anoscopy: differences
The main difference is that an anoscope is shorter than a rectoscope and allows the examination of the anal canal; a rectoscope allows the lower portion of the rectum to also be viewed.
The rectoscope usually has a magnifying glass and an insufflator for a better visualization of the area, thanks to an enlarged view and a gentle dilation of the rectum walls.
Rectoscopy and anoscopy: preparation
To allow proper viewing of the anorectal canal during the examination, the physician normally asks the patient to undergo an enema the day before the test and a few hours before the appointment. No dietary changes, laxatives or drugs are required.
High-Resolution Anoscopy: what is it and what happens
High-resolution anoscopy (HRA) is the evolution of traditional anoscopy and, as with the latter, it can be performed in the outpatient setting without anesthesia.
It is a minimally-invasive procedure and only lasts a few minutes. However, it makes it possible to view, with high precision, lesions in the anus or in the perianal area and to remove or take them for a biopsy.
With HRA the specialist can view magnified images of the anorectal canal on a monitor, record them and compare them with the results of subsequent diagnostic tests.
Today HRA is one of the most reliable instruments for the diagnosis of lesions caused by the HPV virus, even at a very early stage.
With this test, in experienced centers, the physician can immediately confirm or exclude the presence of dysplasia in the anus that might turn into cancer. Biopsy is recommended to accurately identify and grade this type of dysplasia.