Pelvic floor muscle morphology and its association with non-retentive fecal incontinence following surgical treatment for hirschsprung disease in pediatric patients
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View abstract on PubMed
Summary
This summary is machine-generated.Postoperative fecal incontinence in children with congenital megacolon is linked to pelvic floor muscle thickness. Thicker external anal sphincter and puborectalis muscles may protect against incontinence, while long-segment disease increases risk.
Area Of Science
- Pediatric Surgery
- Gastroenterology
- Radiology
- Pelvic Floor Anatomy
Background
- Congenital megacolon (Hirschsprung's disease) is a condition affecting the large intestine, often leading to bowel dysfunction post-surgery.
- Postoperative fecal incontinence is a common complication, impacting quality of life in affected children.
- Pelvic floor muscle development plays a crucial role in anorectal function.
Purpose Of The Study
- To investigate the association between pelvic floor muscle development and postoperative bowel dysfunction in children with congenital megacolon.
- To identify specific muscle parameters and clinical factors that predict non-neurogenic fecal incontinence (NFI) after surgery for congenital megacolon.
Main Methods
- Retrospective analysis of postoperative MRI data from 50 children with congenital megacolon.
- Measurements included rectal position, anal sphincter (EAS) and levator ani complex (puborectalis, pubococcygeus, iliococcygeus, ischiococcygeus) muscle thickness, rectal lumen width, and anorectal angle.
- Children were classified into non-neurogenic fecal incontinence (Group A) and continent (Group B) groups based on Rome IV criteria; clinical and MRI data were compared.
Main Results
- Significant differences in the thickness of the external anal sphincter (EAS) and puborectalis muscles were found between incontinent and continent groups (P < 0.05).
- Multivariate logistic regression identified greater EAS thickness (OR=0.27) and puborectalis thickness (OR=0.35) as independent protective factors against NFI.
- Long-segment congenital megacolon was identified as an independent risk factor for NFI (OR=7.72).
Conclusions
- Postoperative non-retentive fecal incontinence in children with congenital megacolon is associated with pelvic floor muscle thickness and the type of megacolon.
- Thicker external anal sphincter and puborectalis muscles appear to be protective against fecal incontinence.
- Long-segment congenital megacolon is a significant risk factor for developing postoperative fecal incontinence.
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