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Related Experiment Videos

Pudendal neuropathy is the only parameter differentiating leakage from solid stool incontinence

N J Kafka1, J A Coller, R C Barrett

  • 1Department of Colon Rectal Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.

Diseases of the Colon and Rectum
|October 23, 1997
PubMed
Summary

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Female patients with fecal incontinence showed decreased sphincter function and rectal sensitivity. Pudendal nerve function significantly differed between those with gross stool incontinence and those with leakage, indicating its role in maintaining bowel control.

Area of Science:

  • Gastroenterology
  • Urogynecology
  • Neurology

Background:

  • Fecal incontinence presents with varying severity, from minor leakage to gross loss of solid stool.
  • Understanding the physiological differences between these forms is crucial for effective management.

Purpose of the Study:

  • To identify physiological parameters differentiating female patients with solid stool incontinence from those with only leakage.
  • To compare these parameters against a control group of women with normal bowel function.

Main Methods:

  • Evaluated 38 female patients with fecal incontinence using water perfusion manometry, rectal sensitivity tests, and pudendal nerve terminal motor latency.
  • Compared findings with a control group of healthy women.

Main Results:

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  • Both incontinent groups had reduced sphincter length, pressure, and volume, alongside hypersensitive rectums compared to controls.
  • Pudendal nerve function differed significantly: abnormal distal rectoanal excitatory reflex in 58.1% of gross incontinence vs. 28.6% of leakage.
  • Normal pudendal nerve terminal motor latency was more common in leakage patients (65%) than gross incontinence (22.6%).

Conclusions:

  • Normal pudendal nerve function may compensate for sphincter abnormalities, allowing bowel control.
  • Further research is needed to determine if leakage progresses to gross incontinence with age-related nerve conduction changes.