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Does perineal descent correlate with pudendal neuropathy?
J M Jorge1, S D Wexner, E D Ehrenpreis
1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309.
Diseases of the Colon and Rectum
|May 1, 1993
Summary
This study found no correlation between increased perineal descent and pudendal neuropathy in patients with defecation disorders. These conditions often occur together but may be independent findings.
Area of Science:
- Colorectal Surgery
- Pelvic Floor Disorders
- Neurology
Background:
- Increased perineal descent (IPD) and pudendal neuropathy (PN) are frequently observed in patients with defecation disorders.
- The potential correlation between IPD and PN has been suggested but not definitively established.
Purpose of the Study:
- To assess the potential correlation between increased perineal descent and pudendal neuropathy in patients presenting with constipation, fecal incontinence, or rectal pain.
Main Methods:
- A prospective study involving 213 patients (165 female, 48 male) aged 18-87.
- Cinedefecography (CD) and bilateral pudendal nerve terminal motor latency (PNTML) assessments were performed.
- IPD was defined as perineal descent > 3.0 cm during evacuation; PN was diagnosed when PNTML exceeded 2.2 milliseconds.
Main Results:
- Of 213 patients, 65 (31%) had IPD, but only 16 (25%) of them also had PN.
- PN was found in 42 (28%) of 148 patients without IPD.
- Linear regression analysis revealed no significant correlation (r values between -0.050 and 0.048) between measurements of perineal descent and PNTML.
Conclusions:
- This prospective evaluation found no evidence to support a correlation between increased perineal descent and pudendal neuropathy.
- IPD and PN may represent independent findings in patients with disordered defecation, despite their frequent co-occurrence.