Diagnostic Value of Pudendal Nerve Conduction Study and Relationship with Anal Manometry in Fecal Incontinence

ABSTRACT

OBJECTIVE: To evaluate the diagnostic value of pudendal nerve terminal motor latency (PNTML) and the relationship with manometric profiles in patients with fecal incontinence. METHOD: A total of 29 patients with fecal incontinence who visited colorectal clinic were recruited. The PNTMLs of 29 patients were compared with those of normal controls (2.03+/-0.39) using one-sample t test. Patients were classified into three groups according to pudendal nerve latency; Group I (normal latency, n=8), group II (unilaterally delayed latency, n=9), group III (bilaterally delayed latency, n=12) and compared with manometric parameters (mean maximal resting pressure, mean maximal squeezing pressure, 1st sense volume, urge sense volume, maximal tolerance volume). RESULTS: The PNTML is 3.83+/-2.19 in right side, 4.57+/-2.19 in left side which are significantly delayed in patients with fecal incontinence compare to that of normal controls, 2.03+/-0.39. (p=0.031 in Rt., p=0.000 in Lt.) Among group I~III, there were no statistically significant differences in the values of mean maximal resting pressure, mean maximal squeezing pressure, 1st sense volume, urge sense volume and maximal tolerance volume. There was no correlation between the PNTML and any of manometric parameters. CONCLUSION: The PNTML is valuable in diagnosing patients with fecal incontinence. It is suggested that combined assessments are necessary to identify the cause of fecal incontinence.