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Simplified evaluation of the paradoxical puborectalis contraction with surface electrodes.
Dis Colon Rectum. 2010 Jun; 53(6):928-31.DC

Abstract

PURPOSE

Paradoxical puborectalis contraction during defecation is one possible explanation for constipation. The degree of paradoxical contraction can be evaluated by intramuscular electromyography from the puborectalis and external anal sphincter muscles. This study aimed to determine whether a noninvasive technique with surface electrodes placed over the subcutaneous part of the external anal sphincter is feasible in the evaluation of paradoxical activity.

METHODS

Twenty-five patients with constipation were studied. Sphincter muscle activity during strain and squeeze maneuvers was recorded using surface electrodes placed 1 cm from the anal verge. In addition, intramuscular recordings were made simultaneously from the external anal sphincter and puborectalis muscles. The degree of paradoxical activation was calculated as a strain/squeeze index. The patients were examined either in the left lateral position or sitting on a commode.

RESULTS

The study revealed significant (P < .01) correlations between indices obtained from the surface anal sphincter recordings and the intramuscular recordings (from the external anal sphincter and the puborectalis muscles).

CONCLUSION

Surface recordings from the external anal sphincter seem to be an equally reliable, less time consuming, and less painful alternative to invasive measurements of paradoxical activity. In a few patients, however, invasive recordings may still be required.

Authors+Show Affiliations

Department of Neuroscience, Section for Clinical Neurophysiology, Uppsala University, Uppsala, Sweden. hans.axelson@akademiska.seNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20485007

Citation

Axelson, Hans W., and Karin Edebol Eeg-Olofsson. "Simplified Evaluation of the Paradoxical Puborectalis Contraction With Surface Electrodes." Diseases of the Colon and Rectum, vol. 53, no. 6, 2010, pp. 928-31.
Axelson HW, Edebol Eeg-Olofsson K. Simplified evaluation of the paradoxical puborectalis contraction with surface electrodes. Dis Colon Rectum. 2010;53(6):928-31.
Axelson, H. W., & Edebol Eeg-Olofsson, K. (2010). Simplified evaluation of the paradoxical puborectalis contraction with surface electrodes. Diseases of the Colon and Rectum, 53(6), 928-31. https://doi.org/10.1007/DCR.0b013e3181d601e0
Axelson HW, Edebol Eeg-Olofsson K. Simplified Evaluation of the Paradoxical Puborectalis Contraction With Surface Electrodes. Dis Colon Rectum. 2010;53(6):928-31. PubMed PMID: 20485007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simplified evaluation of the paradoxical puborectalis contraction with surface electrodes. AU - Axelson,Hans W, AU - Edebol Eeg-Olofsson,Karin, PY - 2010/5/21/entrez PY - 2010/5/21/pubmed PY - 2010/6/11/medline SP - 928 EP - 31 JF - Diseases of the colon and rectum JO - Dis. Colon Rectum VL - 53 IS - 6 N2 - PURPOSE: Paradoxical puborectalis contraction during defecation is one possible explanation for constipation. The degree of paradoxical contraction can be evaluated by intramuscular electromyography from the puborectalis and external anal sphincter muscles. This study aimed to determine whether a noninvasive technique with surface electrodes placed over the subcutaneous part of the external anal sphincter is feasible in the evaluation of paradoxical activity. METHODS: Twenty-five patients with constipation were studied. Sphincter muscle activity during strain and squeeze maneuvers was recorded using surface electrodes placed 1 cm from the anal verge. In addition, intramuscular recordings were made simultaneously from the external anal sphincter and puborectalis muscles. The degree of paradoxical activation was calculated as a strain/squeeze index. The patients were examined either in the left lateral position or sitting on a commode. RESULTS: The study revealed significant (P < .01) correlations between indices obtained from the surface anal sphincter recordings and the intramuscular recordings (from the external anal sphincter and the puborectalis muscles). CONCLUSION: Surface recordings from the external anal sphincter seem to be an equally reliable, less time consuming, and less painful alternative to invasive measurements of paradoxical activity. In a few patients, however, invasive recordings may still be required. SN - 1530-0358 UR - https://www.unboundmedicine.com/medline/citation/20485007/Simplified_evaluation_of_the_paradoxical_puborectalis_contraction_with_surface_electrodes_ L2 - http://dx.doi.org/10.1007/DCR.0b013e3181d601e0 DB - PRIME DP - Unbound Medicine ER -