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Anorectal manometry and pudendal neuropathy association in fecal incontinence patients

BACKGROUND: Fecal incontinence stands for inability in maintaining the control of defecation to a socially acceptable and adequate time and place, resulting in unwanted release of gas, liquid or solid stool. The diagnosis needs multiple exams. Anorectal manometry is mandatory for this study. The correlation between manometry with electophysiological studies and symptoms is not yet clear in the literature. AIMS: Correlate values of anal manometry, pudental nerve terminal motor latency and co morbidity in fecal incontinence patients. METHODOLOGY AND PATIENTS: Patients with clinical fecal incontinence, who attended the outpatient department of "Hospital Nossa Senhora da Conceição", Porto Alegre, RS, Brazil, between March 1997 and June 2000, were studied prospectively. Every single patient has undergone a general investigation, incontinence score, anal manometry, bilateral pudendal nerve terminal motor latency and physical examination. For statistical purposes the patients were separated in groups according to the results of the anal manometry, pudendal neuropathy, for age and sex. RESULTS/CONCLUSION: Thirty-nine patients were studied, 85,6% female, average age 60,1 years (± 12,89). The average index of the fecal incontinence was of 9,30 (± 4,93). In the anorectal manometry 23 patients showed low pressure. The pressures were significantly higher among males. The nerve terminal motor latency and pudental nerve (neuropathy) time was greater in 14 patients (35,9%). The age and the time of pudental nerve terminal motor were significantly co related. The other co relations were not statistically significant.

Fecal incontinence; Manometry; Anus; Rectum; Defecation; Electrophysiology


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