Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedba...Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.展开更多
PURPOSE:Several clinical,urodynamic,and manometric findings suggest neurologic damage as a contributing factor in the development of combined fecal and urinary incontinence.In this study,we wanted to test the hypothes...PURPOSE:Several clinical,urodynamic,and manometric findings suggest neurologic damage as a contributing factor in the development of combined fecal and urinary incontinence.In this study,we wanted to test the hypothesis of pudendal nerve neuropathy being a more frequent lesion in patients with double incontinence compared with patients with isolated fecal incontinence.PATIENTS:Ninety-three females with combined fecal and urinary incontinence and 36 females with isolated fecal incontinence were investigated.All patients underwent anal manometry,endoanal ultrasound,electromyography,and pudendal nerve terminal motor latency.RESULTS:No statistically significant differences were found in the age,history of vaginal delivery,and chronic straining between both groups.However,the rate of postmenopausal females was higher in the combined fecal and urinary incontinence group(85 vs.67 percent;P = 0.02).Menopause was an independent risk factor of having double incontinence(odds ratio,1.4;P = 0.02).Concentric needle electromyography of the external anal sphincter revealed increased duration of the motor unit potentials in 43 and 53 percent of patients with combined fecal and urinary incontinence and isolated fecal incontinence,respectively(P = 0.28).An increased number of polyphasic motor unit potentials was detected in 52 and 58 percent(P = 0.6).There was no statistically significant difference in the prevalence of bilateral(20 vs.27 percent)or unilateral(23 vs.14 percent)prolonged mean pudendal nerve terminal motor latency between both groups(P = 0.3).CONCLUSIONS:Pudendal neuropathy is not a distinct characteristic of patients with double incontinence.The prevalence of pudendal neuropathy in these patients is similar to that observed in patients with isolated fecal incontinence.Others factors should be investigated to explain the common association of both types of incontinence.展开更多
文摘Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma.
文摘PURPOSE:Several clinical,urodynamic,and manometric findings suggest neurologic damage as a contributing factor in the development of combined fecal and urinary incontinence.In this study,we wanted to test the hypothesis of pudendal nerve neuropathy being a more frequent lesion in patients with double incontinence compared with patients with isolated fecal incontinence.PATIENTS:Ninety-three females with combined fecal and urinary incontinence and 36 females with isolated fecal incontinence were investigated.All patients underwent anal manometry,endoanal ultrasound,electromyography,and pudendal nerve terminal motor latency.RESULTS:No statistically significant differences were found in the age,history of vaginal delivery,and chronic straining between both groups.However,the rate of postmenopausal females was higher in the combined fecal and urinary incontinence group(85 vs.67 percent;P = 0.02).Menopause was an independent risk factor of having double incontinence(odds ratio,1.4;P = 0.02).Concentric needle electromyography of the external anal sphincter revealed increased duration of the motor unit potentials in 43 and 53 percent of patients with combined fecal and urinary incontinence and isolated fecal incontinence,respectively(P = 0.28).An increased number of polyphasic motor unit potentials was detected in 52 and 58 percent(P = 0.6).There was no statistically significant difference in the prevalence of bilateral(20 vs.27 percent)or unilateral(23 vs.14 percent)prolonged mean pudendal nerve terminal motor latency between both groups(P = 0.3).CONCLUSIONS:Pudendal neuropathy is not a distinct characteristic of patients with double incontinence.The prevalence of pudendal neuropathy in these patients is similar to that observed in patients with isolated fecal incontinence.Others factors should be investigated to explain the common association of both types of incontinence.
