Pudendal nerve terminal motor latency influences surgical outcome in treatment of rectal prolapse
作者:
Elisa Birnbaum,
Linda Stamm,
Janice Rafferty,
Robert Fry,
Ira Kodner,
James Fleshman,
期刊:
Diseases of the Colon & Rectum
(OVID Available online 1996)
卷期:
Volume 39,
issue 11
页码: 1215-1221
ISSN:0012-3706
年代: 1996
出版商: OVID
关键词: Prolapse;Pudendal nerve;Manometry;Rectopexy;Fecal incontinence
数据来源: OVID
摘要:
Purpose:This study was undertaken to document the effect of pudendal nerve function on anal incontinence after repair of rectal prolapse.METHODS:Patients with full rectal prolapse (n=24) were prospectively evaluated by anal manometry and pudendal nerve terminal motor latency (PNTML) before and after surgical correction of rectal prolapse (low anterior resection (LAR; n=13) and retrorectal sacral fixation (RSF; n=11)).RESULTS:Prolapse was corrected in all patients; there were no recurrences during a mean 25‐month follow‐up. Postoperative PNTML was prolonged bilaterally (>2.2 ms) in six patients (3 LAR; 3 RSF); five patients were incontinent (83 percent). PNTML was prolonged unilaterally in eight patients (4 LAR; 4 RSF); three patients were incontinent (38 percent). PNTML was normal in five patients (3 LAR; 2 RSF); one was incontinent (20 percent). Postoperative squeeze pressures were significantly higher for patients with normal PNTML than for those with bilateral abnormal PNTML (145vs.66.5 mmHg;P=0.0151). Patients with unilateral abnormal PNTML had higher postoperative squeeze pressures than those with bilateral abnormal PNTML, but the difference was not significant (94.8vs.66.5 mmHg; P=0.3182). The surgical procedure did not affect postoperative sphincter function or PNTML.CONCLUSION:Injury to the pudendal nerve contributes to postoperative incontinence after repair of rectal prolapse. Status of anal continence after surgical correction of rectal prolapse can be predicted by postoperative measurement of PNTML.
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