Prevalence of pudendal neuropathy in fecal incontinence

Roig, José V.; Villoslada, C; Lledó, Salvador; Solana, Amparo; Buch, Elvira; Alós, Rafael; Hinojosa, Joaquín

doi:10.1007/bf02049731

Cited by 58 publications

(25 citation statements)

References 20 publications

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“…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.…”

Section: Terminal Motor Latency Measurementmentioning

confidence: 96%

Neurophysiological testing in anorectal disorders

Lefaucheur

2005

Muscle and Nerve

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The neurophysiological techniques currently available to evaluate anorectal disorders include concentric needle electromyography (EMG) of the external anal sphincter, anal nerve terminal motor latency (TML) measurement in response to transrectal electrical stimulation or sacral magnetic stimulation, motor evoked potentials (MEPs) of the anal sphincter to transcranial magnetic cortical stimulation, cortical recording of somatosensory evoked potentials (SEPs) to anal nerve stimulation, quantification of electrical or thermal sensory thresholds (QSTs) within the anal canal, sacral anal reflex (SAR) latency measurement in response to pudendal nerve or perianal stimulation, and perianal recording of sympathetic skin responses (SSRs). In most cases, a comprehensive approach using several tests is helpful for diagnosis: needle EMG signs of sphincter denervation or prolonged TML give evidence for anal motor nerve lesion; SEP/QST or SSR abnormalities can suggest sensory or autonomic neuropathy; and in the absence of peripheral nerve disorder, MEPs, SEPs, SSRs, and SARs can assist in demonstrating and localizing spinal or supraspinal disease. Such techniques are complementary to other methods of investigation, such as pelvic floor imaging and anorectal manometry, to establish the diagnosis and guide therapeutic management of neurogenic anorectal disorders.

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Section: Terminal Motor Latency Measurementmentioning

confidence: 96%

Neurophysiological testing in anorectal disorders

Lefaucheur

2005

Muscle and Nerve

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“…Although faecal incontinence may be the result of several causes, the highly prevalent reason is anal sphincter injury, as a result of consequence of obstetrical trauma, anorectal surgery or accidental injury [10] . ERUS is the best choice for imaging the morphology of the anal sphincter, and can recognize defects that are responsible for faecal incontinence.…”

Section: Faecal Incontinencementioning

confidence: 99%

Application of Endorectal Ultrasound in Evaluation of Anorectal Diseases

Cao

Liu

Wen

et al. 2016

International Journal of Radiology

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Endorectal ultrasound (ERUS) has become an acknowledged technique for imaging anal sphincters, rectum and pelvic floor in the patients with different kinds of anorectal diseases. ERUS can accurately depict internal sphincter (IS) and external sphincter (ES). Therefore, it is valuable in the diagnosis of faecal incontinence and perianal fistulae. Besides, it is reliable for staging rectal tumors, even after neoadjuvant therapy, and is widely used in the surveillance of rectal cancer patients. The paper mainly reviews the indications and application of ERUS in clinical practice, and some new developments of ERUS.

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“…These results are consistent with those of previous studies (2,22) , but all these measurements are relevant to therapeutic decision making, as ultrasound can differentiate between incontinent patients with intact anal sphincters and those with sphincter lesions, as well as associate anal pressures and symptoms, providing additional value to select patients for different treatment modalities. Fecal incontinence is multifactorial; different mechanisms are involved (12) and patients with fecal incontinence and intact sphincter may have muscle degeneration, atrophy, or pudendal neuropathy (19,23,25) . Ultrasound can identify clinically occult anal sphincter injuries following vaginal delivery (8,16) .…”

Section: Eas Defect Plus Eas + Ias Defect (N = 33) Anterior Ias (Cm) Vsmentioning

confidence: 99%

Do Changes in Anal Sphincter Anatomy Correlate With Anal Function in Women With a History of Vaginal Delivery?

Murad-Regadas

Dealcanfreitas

Regadas

et al. 2014

Arq. Gastroenterol.

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-Objectives -To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods -Female with fecal incontinence and vaginal delivery were assessed with Wexner's score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Results -Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions -Fecal incontinence symptoms did not correlate with anal pressures and anal sphincter anatomy changes, but women with sphincter defects have shorter anterior EAS and IAS and a longer gap.

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Prevalence of pudendal neuropathy in fecal incontinence

Cited by 58 publications

References 20 publications

Neurophysiological testing in anorectal disorders

Neurophysiological testing in anorectal disorders

Application of Endorectal Ultrasound in Evaluation of Anorectal Diseases

Do Changes in Anal Sphincter Anatomy Correlate With Anal Function in Women With a History of Vaginal Delivery?

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