Document Detail


Studies on pudendal nerve terminal motor latency in patients after ileal J-pouch-anal anastomosis for ulcerative colitis and adenomatous coli in childhood.
MedLine Citation:
PMID:  19453048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: To clarify the neurological function with respect to external anal sphincter (EAS) muscles in child patients with or without soiling after ileal J pouch anal anastomosis (IPAA), we examined the terminal motor latency in the pudendal motor nerves (PNTML). METHODOLOGY: A total of nine patients after IPAA for UC (7 cases) and AC (2 cases) were studied (6 males and 3 females, 10 to 15 with a mean age of 13.8 years). Patients one year after IPAA with soiling were also subdivided by the see page of mucous and/or stool group A (5 cases); rare soiling with loose stool, group B (4 cases); occasional soiling (1 time per 2 or 3 days). However, all patients showed continence 2 years after IPAA (Group C). Group D served as controls without gastrointestinal symptoms and digestive diseases and consisted of 12 subjects (8 males and 4 females aged 12 to 16 years old with a mean age of 14.8 years). Examinations were performed 1 and 2 years after ileostomy closure. Bilateral (left-sided and right-sided) PNTML tests were performed on all patients in order to measure the latency of the response in the bilateral EAS muscle following digitally directed transrectal pudendal nerve stimulation. RESULTS: 1) Values of the PNTML at the right-sided of the PN: The conduction delay in group B was the longest, followed by groups A, C, and D. Moreover, significant differences in PNTML were noted between groups A and B, between groups A and D, between groups B and C, and between groups B and D (p < 0.0001, p = 0.0316, p < 0.0001, p < 0.0001 respectively). There were no significance differences between group A and C or between groups C and D (p = 0.1733, p = 0.2957, respectively). 2) Values of the PNTML at the left-sided of the PN: The conduction delay in group B was the longest, followed by groups A, C, and D. Moreover, significant differences in PNTML were noted between groups A and B, between groups A and D, between groups B and C, and between groups B and D (p < 0.0001, p = 0.0584, p < 0.0001, p < 0.0001 respectively). There were no significance differences between groups A and C or between groups C and D (p = 0.3042, p = 0.2553, respectively). CONCLUSIONS: These findings support the hypothesis that child patients' soiling after IPAA may be caused by damage to the bilateral pudendal motor nerves.
Authors:
Ryouichi Tomita; Seigo Igarashi; Tugumichi Koshinaga; Shigeru Fujisaki; Takeshi Kusafuka
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  56     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  154-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Nippon Dental University Hospital at Tokyo, 2-3-16 Fujimi Chiyoda-ku, Tokyo 102-8158, Japan. rtomita-ndus@mvg.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adenomatous Polyposis Coli / physiopathology*,  surgery*
Adolescent
Anal Canal / innervation*
Anastomosis, Surgical
Child
Colitis, Ulcerative / physiopathology*,  surgery*
Colonic Pouches*
Fecal Incontinence / etiology,  physiopathology*
Female
Humans
Male
Neural Conduction / physiology*
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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