Correlation of pudendal nerve terminal motor latency with the results of anal manometry

Abstract

The PNTML was significantly correlated with SP in patients with incontinence and in the subgroup of patients without an ESD. In the assessment of disordered defaecation PNTML is therefore recommended as an adjunct to anal ultrasound.

Unilateral Pudendal Neuropathy is Common in Patients with Fecal Incontinence

“…33 This is typically reflected in attenuated squeeze pressures, which manifests symptomatically as urge fecal incontinence. [34][35][36] As supported by current understanding of the neurophysiologic control of the anal sphincter, 9,36 the results of this study indicate that pudendal neuropathy, in the absence of a sphincteric defect, is significantly associated with attenuated squeeze pressures. Most previous studies that have examined such an association did not exclude sphincter structural defects in all patients, [36][37][38] although one recent study has assessed the utility of pudendal nerve terminal latencies in idiopathic fecal incontinence.…”

Endocoil magnetic resonance imaging quantification of external anal sphincter atrophy

“…However, prolongation of the pudendal nerve terminal motor latency may re¯ect damage to only the large, heavily myelinated nerve ®bres 33 , and it may be normal even in the presence of EAS atrophy 34,35 . The measurement of pudendal nerve conduction does not assess the innervation to the puborectalis, and it is impossible to record conduction latency on one side in up to 28 per cent of cases 36 . For these reasons only single-®bre EMG, which is accepted as the`gold standard' for anal sphincter denervation, was performed in this study.…”

Neurophysiological testing in anorectal disorders

“…This approach owes its popularity to a number of studies reporting prolonged TMLs in various anorectal disorders, 101,121 such as fecal incontinence, 18,48,58,62,94,120,129,130,142,150,162,166 obstetrical lesions, 141,144,146,152,153,155 perineal descent, 6,51,53,62,77,143 or even constipation. 162,163 Evidence of pudendal/ anal neuropathy, as shown by a prolonged TML, was proposed as a predictive factor for the clinical outcome of biofeedback therapy 67 or surgical repair 13,39,145 of pelvic floor disturbances, even in case of unilateral neuropathy.…”