Tags

Type your tag names separated by a space and hit enter

Results of neurophysiologic evaluation in fecal incontinence.
Dis Colon Rectum. 2000 Sep; 43(9):1256-61.DC

Abstract

PURPOSE

Several methods of neurophysiologic assessment exist in the investigation of patients with fecal incontinence. However, the clinical significance of the information gained is uncertain. The aim of this prospective study was to evaluate the results of pudendal nerve terminal motor latency and fiber density in relation to clinical variables and manometric measurements.

METHODS

Seventy-two patients with fecal incontinence (63 women; mean age, 62; range, 24-81 years) responded to a bowel questionnaire and underwent anorectal manovolumetry, anal ultrasonography, defecography, and electromyography, including pudendal nerve terminal motor latency and fiber density.

RESULTS

Pudendal neuropathy (pudendal nerve terminal motor latency > 2.5 ms) was found in 46 percent and increased fiber density (> 1.7) in 82 percent. Pudendal neuropathy and increased fiber density were most common in patients with rectal prolapse or intra-anal intussusception. No difference was seen concerning anal resting and incremental pressures, rectal compliance, rectal sensibility or severity of incontinence in patients with unilateral, bilateral, or marked (> 4 ms) pudendal neuropathy vs. patients with normal pudendal nerve terminal motor latency. In contrast, patients with increased fiber density had lower incremental pressures (P < 0.05) and stated decreased rectal sensibility (P < 0.05) compared with those with normal fiber density. These differences were most pronounced in patients with neurogenic or idiopathic incontinence.

CONCLUSIONS

Pudendal neuropathy and increased fiber density are common in patients with fecal incontinence. Fiber density but not pudendal nerve terminal motor latency was correlated with clinical and manometric variables. The severity of nerve injury correlated with anal motor and sensory function in patients with neurogenic or idiopathic incontinence. The routine use of pudendal nerve terminal motor latency in the assessment of patients with fecal incontinence can be questioned.

Authors+Show Affiliations

Department of Surgery, University Hospital, Uppsala, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11005493

Citation

Osterberg, A, et al. "Results of Neurophysiologic Evaluation in Fecal Incontinence." Diseases of the Colon and Rectum, vol. 43, no. 9, 2000, pp. 1256-61.
Osterberg A, Graf W, Edebol Eeg-Olofsson K, et al. Results of neurophysiologic evaluation in fecal incontinence. Dis Colon Rectum. 2000;43(9):1256-61.
Osterberg, A., Graf, W., Edebol Eeg-Olofsson, K., Hynninen, P., & Påhlman, L. (2000). Results of neurophysiologic evaluation in fecal incontinence. Diseases of the Colon and Rectum, 43(9), 1256-61.
Osterberg A, et al. Results of Neurophysiologic Evaluation in Fecal Incontinence. Dis Colon Rectum. 2000;43(9):1256-61. PubMed PMID: 11005493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of neurophysiologic evaluation in fecal incontinence. AU - Osterberg,A, AU - Graf,W, AU - Edebol Eeg-Olofsson,K, AU - Hynninen,P, AU - Påhlman,L, PY - 2000/9/27/pubmed PY - 2000/10/14/medline PY - 2000/9/27/entrez SP - 1256 EP - 61 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 43 IS - 9 N2 - PURPOSE: Several methods of neurophysiologic assessment exist in the investigation of patients with fecal incontinence. However, the clinical significance of the information gained is uncertain. The aim of this prospective study was to evaluate the results of pudendal nerve terminal motor latency and fiber density in relation to clinical variables and manometric measurements. METHODS: Seventy-two patients with fecal incontinence (63 women; mean age, 62; range, 24-81 years) responded to a bowel questionnaire and underwent anorectal manovolumetry, anal ultrasonography, defecography, and electromyography, including pudendal nerve terminal motor latency and fiber density. RESULTS: Pudendal neuropathy (pudendal nerve terminal motor latency > 2.5 ms) was found in 46 percent and increased fiber density (> 1.7) in 82 percent. Pudendal neuropathy and increased fiber density were most common in patients with rectal prolapse or intra-anal intussusception. No difference was seen concerning anal resting and incremental pressures, rectal compliance, rectal sensibility or severity of incontinence in patients with unilateral, bilateral, or marked (> 4 ms) pudendal neuropathy vs. patients with normal pudendal nerve terminal motor latency. In contrast, patients with increased fiber density had lower incremental pressures (P < 0.05) and stated decreased rectal sensibility (P < 0.05) compared with those with normal fiber density. These differences were most pronounced in patients with neurogenic or idiopathic incontinence. CONCLUSIONS: Pudendal neuropathy and increased fiber density are common in patients with fecal incontinence. Fiber density but not pudendal nerve terminal motor latency was correlated with clinical and manometric variables. The severity of nerve injury correlated with anal motor and sensory function in patients with neurogenic or idiopathic incontinence. The routine use of pudendal nerve terminal motor latency in the assessment of patients with fecal incontinence can be questioned. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/11005493/Results_of_neurophysiologic_evaluation_in_fecal_incontinence_ L2 - http://link.springer.com/article/10.1007/BF02237432 DB - PRIME DP - Unbound Medicine ER -