Tags

Type your tag names separated by a space and hit enter

Pudendal neuropathy and the importance of EMG evaluation of fecal incontinence.
Dis Colon Rectum. 1993 Jan; 36(1):23-7.DC

Abstract

A prospective study was undertaken to evaluate pudendal neuropathy in fecal incontinence. Fifty-two patients (38 women and 14 men) with fecal incontinence underwent manometric and electromyographic evaluation (measurement of pudendal nerve terminal motor latency [PNTML] and sphincter muscle mapping). The average age of all patients was 54 +/- 17 years. Fifty-two percent (27/52) were found to have a pudendal neuropathy (PNTML > 2.1 milliseconds). Seventeen of these 27 patients (63 percent) had a bilateral pudendal neuropathy. Patients with a pudendal neuropathy were older than those without a neuropathy (63.7 years vs. 51.9 years; P = 0.01). Women were significantly more likely than men to have a pudendal neuropathy (P = 0.03). Nine patients had an anatomic sphincter defect identified, and six of these (67 percent) had a neuropathy; 4/6 (67 percent) had a bilateral pudendal neuropathy. In the 43 patients who did not have an anatomic sphincter defect, there was no difference in resting pressure (69 mmHg vs. 60 mmHg; P = 0.4) or maximum voluntary contraction (95 mmHg vs. 86 mmHg; P = 0.5) when patients without a neuropathy were compared with those with a neuropathy. Patients with a pudendal neuropathy had a shorter sphincter length than those without a neuropathy (3.0 cm vs. 3.9 cm; P = 0.01). Bilateral pudendal neuropathy tended to occur more frequently in women (P = 0.08) and was not associated with poorer resting pressure, maximum voluntary contraction, or shorter sphincter length. We conclude that pudendal neuropathy is a common cause of fecal incontinence, particularly in older women, and frequently occurs in association with a sphincter defect. Manometric evaluation alone is not helpful in identifying the neuropathic patient. PNTMLs should be routinely measured in the evaluation of fecal incontinence.

Authors+Show Affiliations

Department of Surgery, St. Louis University School of Medicine, Missouri 63110.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8380139

Citation

Vernava, A M., et al. "Pudendal Neuropathy and the Importance of EMG Evaluation of Fecal Incontinence." Diseases of the Colon and Rectum, vol. 36, no. 1, 1993, pp. 23-7.
Vernava AM, Longo WE, Daniel GL. Pudendal neuropathy and the importance of EMG evaluation of fecal incontinence. Dis Colon Rectum. 1993;36(1):23-7.
Vernava, A. M., Longo, W. E., & Daniel, G. L. (1993). Pudendal neuropathy and the importance of EMG evaluation of fecal incontinence. Diseases of the Colon and Rectum, 36(1), 23-7.
Vernava AM, Longo WE, Daniel GL. Pudendal Neuropathy and the Importance of EMG Evaluation of Fecal Incontinence. Dis Colon Rectum. 1993;36(1):23-7. PubMed PMID: 8380139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pudendal neuropathy and the importance of EMG evaluation of fecal incontinence. AU - Vernava,A M,3rd AU - Longo,W E, AU - Daniel,G L, PY - 1993/1/1/pubmed PY - 1993/1/1/medline PY - 1993/1/1/entrez SP - 23 EP - 7 JF - Diseases of the colon and rectum JO - Dis Colon Rectum VL - 36 IS - 1 N2 - A prospective study was undertaken to evaluate pudendal neuropathy in fecal incontinence. Fifty-two patients (38 women and 14 men) with fecal incontinence underwent manometric and electromyographic evaluation (measurement of pudendal nerve terminal motor latency [PNTML] and sphincter muscle mapping). The average age of all patients was 54 +/- 17 years. Fifty-two percent (27/52) were found to have a pudendal neuropathy (PNTML > 2.1 milliseconds). Seventeen of these 27 patients (63 percent) had a bilateral pudendal neuropathy. Patients with a pudendal neuropathy were older than those without a neuropathy (63.7 years vs. 51.9 years; P = 0.01). Women were significantly more likely than men to have a pudendal neuropathy (P = 0.03). Nine patients had an anatomic sphincter defect identified, and six of these (67 percent) had a neuropathy; 4/6 (67 percent) had a bilateral pudendal neuropathy. In the 43 patients who did not have an anatomic sphincter defect, there was no difference in resting pressure (69 mmHg vs. 60 mmHg; P = 0.4) or maximum voluntary contraction (95 mmHg vs. 86 mmHg; P = 0.5) when patients without a neuropathy were compared with those with a neuropathy. Patients with a pudendal neuropathy had a shorter sphincter length than those without a neuropathy (3.0 cm vs. 3.9 cm; P = 0.01). Bilateral pudendal neuropathy tended to occur more frequently in women (P = 0.08) and was not associated with poorer resting pressure, maximum voluntary contraction, or shorter sphincter length. We conclude that pudendal neuropathy is a common cause of fecal incontinence, particularly in older women, and frequently occurs in association with a sphincter defect. Manometric evaluation alone is not helpful in identifying the neuropathic patient. PNTMLs should be routinely measured in the evaluation of fecal incontinence. SN - 0012-3706 UR - https://www.unboundmedicine.com/medline/citation/8380139/Pudendal_neuropathy_and_the_importance_of_EMG_evaluation_of_fecal_incontinence_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8380139.ui DB - PRIME DP - Unbound Medicine ER -