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Pudendal neuropathy in evacuatory disorders
C A Vaccaro1, D M Cheong, S D Wexner
1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale.
Diseases of the Colon and Rectum
|February 1, 1995
Summary
Pudendal neuropathy, a nerve condition, is common in patients with constipation and fecal incontinence, particularly those over 70. Pudendal nerve terminal motor latency testing is useful for incontinence evaluation.
Area of Science:
- Neuroscience
- Gastroenterology
- Urology
Background:
- Pudendal neuropathy is a potential cause of constipation and fecal incontinence.
- Age is a significant factor in the development of pudendal neuropathy.
Purpose of the Study:
- Assess the frequency of pudendal neuropathy in patients with constipation and fecal incontinence.
- Correlate pudendal neuropathy with clinical factors, anal electromyography, and manometry.
- Evaluate the utility of pudendal nerve terminal motor latency (PNTML) testing.
Main Methods:
- 395 patients (172 constipated, 223 incontinent) underwent PNTML, electromyography, and anal manometry.
- Pudendal neuropathy defined as PNTML > 2.2 ms.
- Data collected between 1988 and 1993.
Main Results:
- Overall incidence of pudendal neuropathy was 31.4% (23.8% constipated, 37.2% incontinent).
- Incidence increased significantly in patients over 70 years old.
- Pudendal neuropathy correlated with reduced motor unit potentials in incontinent patients but not with manometric pressures.
Conclusions:
- Pudendal neuropathy is age-related and prevalent in patients with evacuatory dysfunction.
- PNTML assessment is valuable for evaluating fecal incontinence.
- The role of PNTML in assessing constipation requires further investigation.