title: Striated anal sphincter electromyography in idiopathic fecal incontinence.
abstract: OBJECTIVE
  This study was designed to determine the importance of innervation of striated anal sphincters, one of the most important structures in idiopathic fecal incontinence.
  
  
  METHODS
  Forty-three idiopathic, fecally incontinent patients (40 women and 3 men; mean age, 57.2 +/- 11 (range, 33-77) years) underwent anorectal manometry and sphincteric electromyography. On the basis of electromyographic findings, patients were subdivided into three groups: Group A consisted of 21 patients with normal electromyography; Group B consisted of 14 patients with moderate denervation; Group C consisted of 8 patients with severe denervation. Manometric results from the patients were compared with those from 15 healthy subjects (8 women and 7 men; mean age, 35 +/- 12 (range, 15-55) years).
  
  
  RESULTS
  Incontinent patients had a shorter anal canal (P = 0.005), and anal canal pressure was lower at rest (P < 0.001), at contraction (P < 0.001), and at coughing (P < 0.001); rectal distention and rectal compliance were reduced (maximum tolerated volume, P < 0.003; compliance at 200 ml, P = 0.03; at 250, P < 0.005; at 300 ml, P = 0.03). No statistically significant differences were found between the manometric results of the three different groups of patients. A statistically significant linear correlation was reached by comparing the clinical severity of fecal incontinence with age (P = 0.02) and some other manometric parameters: the pressure of the anal canal at rest (P < 0.001) and at contraction (P < 0.01); rectal compliance at 50 ml (P = 0.03), 100 ml (P = 0.004), and 150 ml (P = 0.004).
  
  
  CONCLUSIONS
  Clinical severity of fecal incontinence is correlated with some manometric parameters. Severity of denervation of the anal striated sphincters does not appear to influence severity of fecal incontinence.
authors: University of Padova, Istituto di Clinica Chirurgica II, Italy.
authors: A
authors: A
authors: Infantino
authors: E
authors: E
authors: Melega
authors: P
authors: P
authors: Negrin
authors: A
authors: A
authors: Masin
authors: S
authors: S
authors: Carnio
authors: M
authors: M
authors: Lise
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000294:innervation* / Q000503:physiopathology*; D004576:Electromyography; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012720:Severity of Illness Index