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The relationship of pudendal nerve terminal motor latency to squeeze pressure in patients with idiopathic fecal incontinence.
Dis Colon Rectum. 2001 May; 44(5):666-71.DC

Abstract

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+Show Affiliations

Departments of Coloproctology and Radiology, Glasgow Royal Infirmary, Glasgow, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11357026

Citation

Súilleabháin, C B., et al. "The Relationship of Pudendal Nerve Terminal Motor Latency to Squeeze Pressure in Patients With Idiopathic Fecal Incontinence." Diseases of the Colon and Rectum, vol. 44, no. 5, 2001, pp. 666-71.
Súilleabháin CB, Horgan AF, McEnroe L, et al. The relationship of pudendal nerve terminal motor latency to squeeze pressure in patients with idiopathic fecal incontinence. Dis Colon Rectum. 2001;44(5):666-71.
Súilleabháin, C. B., Horgan, A. F., McEnroe, L., Poon, F. W., Anderson, J. H., Finlay, I. G., & McKee, R. F. (2001). The relationship of pudendal nerve terminal motor latency to squeeze pressure in patients with idiopathic fecal incontinence. Diseases of the Colon and Rectum, 44(5), 666-71.
Súilleabháin CB, et al. The Relationship of Pudendal Nerve Terminal Motor Latency to Squeeze Pressure in Patients With Idiopathic Fecal Incontinence. Dis Colon Rectum. 2001;44(5):666-71. PubMed PMID: 11357026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship of pudendal nerve terminal motor latency to squeeze pressure in patients with idiopathic fecal incontinence. AU - Súilleabháin,C B, AU - Horgan,A F, AU - McEnroe,L, AU - Poon,F W, AU - Anderson,J H, AU - Finlay,I G, AU - McKee,R F, PY - 2001/5/18/pubmed PY - 2001/6/8/medline PY - 2001/5/18/entrez SP - 666 EP - 71 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 44 IS - 5 N2 - 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. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/11357026/The_relationship_of_pudendal_nerve_terminal_motor_latency_to_squeeze_pressure_in_patients_with_idiopathic_fecal_incontinence_ L2 - http://link.springer.com/article/10.1007/BF02234563 DB - PRIME DP - Unbound Medicine ER -