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Preoperative electrophysiologic assessment cannot predict continence after rectopexy
I Schultz1, A Mellgren, B Y Nilsson
1Department of Surgery, Karolinska Institute at Danderyd Hospital, Stockholm, Sweden.
Purpose:
The aim of this study was to evaluate preoperative electrophysiologic assessment for prediction of anal continence after rectopexy.
Methods:
Forty-three patients with rectal prolapse (n = 26) or internal rectal intussusception (n = 17) underwent concentric-needle electromyography, fiber density determination by single-fiber electromyography of the external anal sphincter, and pudendal nerve terminal motor latency evaluation before Ripstein rectopexy. A detailed history was obtained from each patient preoperatively and postoperatively.
Results:
Anal continence was improved after rectopexy, both in patients with rectal prolapse (P = 0.06) and in those with internal rectal intussusception (P = 0.003). Abnormal results were registered in one or several aspects of the electrophysiologic assessment in 31 (72 percent) of the patients. However, functional outcome with respect to continence was not predicted by preoperative electromyography or pudendal nerve terminal motor latency assessment results.
Conclusion:
Electrophysiologic examinations in the preoperative assessment of patients with rectal prolapse and internal rectal intussusception do not predict continence after the Ripstein rectopexy. The routine use of electrophysiologic assessment requires further definition.