A study on anal and urinary incontinence

February 20, 2008

An interesting study …

nne

Dr. Beco also discusses it in his

publication.

: BMC Surg. 2004 Oct 30;4:15.

Pudendal nerve decompression in

perineology: a case series.

Beco J, Climov D, Bex M.

Gynaecology, CHU Sart-Tilman, University of

Liège, B-4000 Liège, Belgium. jacques.beco@...

BACKGROUND: Perineodynia (vulvodynia,

perineal pain, proctalgia), anal and urinary incontinence are the main symptoms

of the pudendal canal syndrome (PCS) or entrapment of the pudendal nerve. The

first aim of this study was to evaluate the effect of bilateral pudendal nerve

decompression (PND) on the symptoms of the PCS, on three clinical signs

(abnormal sensibility, painful Alcock's canal, painful " skin rolling

test " ) and on two neurophysiological tests: electromyography (EMG) and

pudendal nerve terminal motor latencies (PNTML). The second aim was to study

the clinical value of the aforementioned clinical signs in the diagnosis of

PCS. METHODS: In this retrospective analysis, the studied sample comprised 74

female patients who underwent a bilateral PND between 1995 and 2002. To

accomplish the first aim, the patients sample was compared before and at least

one year after surgery by means of descriptive statistics and hypothesis

testing. The second aim was achieved by means of a statistical comparison

between the patient's group before the operation and a control group of 82

women without any of the following signs: prolapse, anal incontinence,

perineodynia, dyschesia and history of pelvi-perineal surgery. RESULTS: When

bilateral PND was the only procedure done to treat the symptoms, the cure rates

of perineodynia, anal incontinence and urinary incontinence were 8/14, 4/5 and

3/5, respectively. The frequency of the three clinical signs was significantly

reduced. There was a significant reduction of anal and perineal PNTML and a

significant increase of anal richness on EMG. The Odd Ratio of the three

clinical signs in the diagnosis of PCS was 16,97 (95% CI = 4,68 - 61,51).

CONCLUSION: This study suggests that bilateral PND can treat perineodynia, anal

and urinary incontinence. The three clinical signs of PCS seem to be efficient

to suspect this diagnosis. There is a need for further studies to confirm these

preliminary results.

PMID: 15516268 [PubMed - indexed for

MEDLINE

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