Document Detail


The relationship of pudendal nerve terminal motor latency to squeeze pressure in patients with idiopathic fecal incontinence.
MedLine Citation:
PMID:  11357026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: With the advent of transanal ultrasonography it has been possible to identify those incontinent patients without sphincter defects. The majority of these patients are now thought to have neurogenic fecal incontinence secondary to pudendal neuropathy. They have been found to have reduced anal sphincter pressures and increased pudendal nerve terminal motor latencies. The aim of this study was to determine whether in those incontinent patients who do not have a sphincter defect, prolonged pudendal nerve terminal motor latency correlates with anal manometry, in particular maximum squeeze pressure. METHODS: Sixty-six incontinent patients were studied with transanal ultrasonography, anorectal manometry, and pudendal nerve terminal motor latency. Twenty-seven continent controls had anorectal manometry and pudendal nerve terminal motor latency measured. RESULTS: Maximum resting pressure and maximum squeeze pressure were significantly lower in the group of incontinent patients with bilateral prolonged pudendal nerve terminal motor latency (median maximum resting pressure = 26.5 mmHg; median maximum squeeze pressure = 60 mmHg) when compared with incontinent patients with normal bilateral pudendal nerve terminal motor latencies (median maximum resting pressure = 46 mmHg; median maximum squeeze pressure = 79 mmHg; maximum resting pressure P = 0.004; and maximum squeeze pressure P = 0.04). In incontinent patients with no sphincter defects no correlation between pudendal nerve terminal motor latency and maximum squeeze pressure was found (r = -0.109, P = 0.48) and maximum squeeze pressure did not correlate with bilateral or unilateral prolonged pudendal nerve terminal motor latency (r = -0.148, P = 0.56 and r = 0.355, P = 0.19 respectively). CONCLUSIONS: In patients with idiopathic fecal incontinence damage to the pelvic floor is more complex than damage to the pudendal nerve alone. Although increased pudendal nerve terminal motor latency may indicate that neuropathy is present, in patients with neuropathic fecal incontinence, pudendal nerve terminal motor latency does not correlate with maximum squeeze pressure. Normal pudendal nerve terminal motor latency does not exclude weakness of the pelvic floor.
Authors:
C B Súilleabháin; A F Horgan; L McEnroe; F W Poon; J H Anderson; I G Finlay; R F McKee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  44     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-17     Completed Date:  2001-06-07     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666-71     Citation Subset:  IM    
Affiliation:
Departments of Coloproctology and Radiology, Glasgow Royal Infirmary, Glasgow, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / innervation*,  pathology
Fecal Incontinence / physiopathology*
Female
Humans
Male
Manometry
Middle Aged
Motor Neurons / pathology
Pelvic Floor / innervation*
Peripheral Nervous System Diseases / complications*
Pressure

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


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