Pelvic floor electrophysiology patterns associated with faecal incontinence

ABSTRACT

Pelvic floor electrophysiological tests are essential for assessment of patients with faecal incontinence. The present study was conducted to determine the patterns of pelvic floor electrophysiology that are associated with faecal incontinence. The present study included 40 patients with faecal incontinence and 20 apparently healthy subjects as a control group. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, anal manometry and electrophysiological studies. Electrophysiological studies included pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of the external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which include pudendal nerve motor conduction study, pudendo anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristic of faecal incontinence was pudendal neuropathy, abnormal pudendo-anal reflex, denervation of the external anal sphincter and puborectalis at rest, incomplete interference pattern of the external anal sphincter and puborectalis at squeezing and cough and a localized defect in the external anal sphincter. There were characteristic pelvic floor electrodiagnostic patterns for faecal incontinence