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Electrophysiologic studies and clinical findings in females with combined fecal and urinary incontinence: a prospective study.
Dis Colon Rectum. 2006 Mar; 49(3):353-9.DC

Abstract

PURPOSE

Several clinical, urodynamic, and manometric findings suggest neurologic damage as a contributing factor in the development of combined fecal and urinary incontinence. In this study, we wanted to test the hypothesis of pudendal nerve neuropathy being a more frequent lesion in patients with double incontinence compared with patients with isolated fecal incontinence.

PATIENTS

Ninety-three females with combined fecal and urinary incontinence and 36 females with isolated fecal incontinence were investigated. All patients underwent anal manometry, endoanal ultrasound, electromyography, and pudendal nerve terminal motor latency.

RESULTS

No statistically significant differences were found in the age, history of vaginal delivery, and chronic straining between both groups. However, the rate of postmenopausal females was higher in the combined fecal and urinary incontinence group (85 vs. 67 percent; P = 0.02). Menopause was an independent risk factor of having double incontinence (odds ratio, 1.4; P = 0.02). Concentric needle electromyography of the external anal sphincter revealed increased duration of the motor unit potentials in 43 and 53 percent of patients with combined fecal and urinary incontinence and isolated fecal incontinence, respectively (P = 0.28). An increased number of polyphasic motor unit potentials was detected in 52 and 58 percent (P = 0.6). There was no statistically significant difference in the prevalence of bilateral (20 vs. 27 percent) or unilateral (23 vs. 14 percent) prolonged mean pudendal nerve terminal motor latency between both groups (P = 0.3).

CONCLUSIONS

Pudendal neuropathy is not a distinct characteristic of patients with double incontinence. The prevalence of pudendal neuropathy in these patients is similar to that observed in patients with isolated fecal incontinence. Others factors should be investigated to explain the common association of both types of incontinence.

Authors+Show Affiliations

Digestive Motility Unit, Digestive Diseases Institut, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Catalonia, Spain. glacima@clinic.ub.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16463137

Citation

Lacima, Gloria, et al. "Electrophysiologic Studies and Clinical Findings in Females With Combined Fecal and Urinary Incontinence: a Prospective Study." Diseases of the Colon and Rectum, vol. 49, no. 3, 2006, pp. 353-9.
Lacima G, Pera M, Valls-Solé J, et al. Electrophysiologic studies and clinical findings in females with combined fecal and urinary incontinence: a prospective study. Dis Colon Rectum. 2006;49(3):353-9.
Lacima, G., Pera, M., Valls-Solé, J., González-Argenté, X., Puig-Clota, M., & Espuña, M. (2006). Electrophysiologic studies and clinical findings in females with combined fecal and urinary incontinence: a prospective study. Diseases of the Colon and Rectum, 49(3), 353-9.
Lacima G, et al. Electrophysiologic Studies and Clinical Findings in Females With Combined Fecal and Urinary Incontinence: a Prospective Study. Dis Colon Rectum. 2006;49(3):353-9. PubMed PMID: 16463137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrophysiologic studies and clinical findings in females with combined fecal and urinary incontinence: a prospective study. AU - Lacima,Gloria, AU - Pera,Miguel, AU - Valls-Solé,Josep, AU - González-Argenté,Xavier, AU - Puig-Clota,Montserrat, AU - Espuña,Montserrat, PY - 2006/2/8/pubmed PY - 2006/4/25/medline PY - 2006/2/8/entrez SP - 353 EP - 9 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 49 IS - 3 N2 - PURPOSE: Several clinical, urodynamic, and manometric findings suggest neurologic damage as a contributing factor in the development of combined fecal and urinary incontinence. In this study, we wanted to test the hypothesis of pudendal nerve neuropathy being a more frequent lesion in patients with double incontinence compared with patients with isolated fecal incontinence. PATIENTS: Ninety-three females with combined fecal and urinary incontinence and 36 females with isolated fecal incontinence were investigated. All patients underwent anal manometry, endoanal ultrasound, electromyography, and pudendal nerve terminal motor latency. RESULTS: No statistically significant differences were found in the age, history of vaginal delivery, and chronic straining between both groups. However, the rate of postmenopausal females was higher in the combined fecal and urinary incontinence group (85 vs. 67 percent; P = 0.02). Menopause was an independent risk factor of having double incontinence (odds ratio, 1.4; P = 0.02). Concentric needle electromyography of the external anal sphincter revealed increased duration of the motor unit potentials in 43 and 53 percent of patients with combined fecal and urinary incontinence and isolated fecal incontinence, respectively (P = 0.28). An increased number of polyphasic motor unit potentials was detected in 52 and 58 percent (P = 0.6). There was no statistically significant difference in the prevalence of bilateral (20 vs. 27 percent) or unilateral (23 vs. 14 percent) prolonged mean pudendal nerve terminal motor latency between both groups (P = 0.3). CONCLUSIONS: Pudendal neuropathy is not a distinct characteristic of patients with double incontinence. The prevalence of pudendal neuropathy in these patients is similar to that observed in patients with isolated fecal incontinence. Others factors should be investigated to explain the common association of both types of incontinence. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/16463137/Electrophysiologic_studies_and_clinical_findings_in_females_with_combined_fecal_and_urinary_incontinence:_a_prospective_study_ L2 - http://link.springer.com/article/10.1007/s10350-005-0277-4 DB - PRIME DP - Unbound Medicine ER -