Pudendal Nerve Terminal Motor Latency Compared by Anorectal Manometry Diagnosing Fecal Incontinence

Abstract

The aim of the study was to compare the clinical value of pudendal nerve terminal motor latency in fecal incontinence patients with that of another diagnostic test-anorectal manometry. Design: This study used a cross-sectional design. Medical records of fecal incontinence patients who underwent pudendal nerve terminal motor latency and anorectal manometry testing were reviewed. Greater than 2.4 ms of pudendal nerve terminal motor latency was determined to be abnormal. Anorectal manometry was performed using a station pull-through technique. Mean resting anal pressure, maximal resting anal pressure, mean squeezing anal pressure, and maximal squeezing anal pressure were investigated. For normal and abnormal pudendal nerve terminal motor latency groups, comparative analyses were performed on anorectal manometry results. Results: A total of 31 patients were included. Thirteen patients showed normal pudendal nerve terminal motor latency. For anorectal manometry results, there was no significant difference between normal and abnormal pudendal nerve terminal motor latency groups. Fourteen patients had diabetes mellitus. Subgroup analysis of the 14 diabetic patients showed no significant difference between normal and abnormal pudendal nerve terminal motor latency groups. For 17 nondiabetic patients, there was a significant difference between the groups with positive correlations with mean/maximal resting anal pressures. Conclusions: Pudendal nerve terminal motor latency significantly correlates with anorectal manometry in fecal incontinence only in nondiabetic patients.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Fecal Incontinence

“…No studies have been published in support of this testing modality since 2013, and the 2 more recent studies did not support this test for clinical decision-making. 73,87…”

“…No studies have been published in support of this testing modality since 2013, and the 2 more recent studies did not support this test for clinical decision-making. 73,87 Copyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited.…”

Biofeedback combined with percutaneous electrical pudendal nerve stimulation for the treatment of low anterior rectal resection syndrome: a study protocol for a randomized controlled trial

“…The inferior rectal branch innervates the external anal sphincter, levator ani, lower anal canal, and perianal skin [ 17 ]. The suggested mechanism involves continual electrical stimulation of the pudendal nerve alongside the merging of incoming nerve fibers from the anorectal region at the common neurons in the S2-S4 spinal segments, which regulate the visceral nerves [ 18 , 19 ]. Moreover, pudendal nerve electrical stimulation can increase resting pressure in the sphincter, thus enhancing bowel control.…”