Does squatting reduce pelvic floor descent during defaecation?
Neurogenic faecal and urinary incontinence result from a stretch-induced injury to the pelvic nerves, from difficult childbirth or from chronic straining at stool. It has been suggested that the condition occurs less frequently in societies where the squatting position is used during defaecation, and that squatting may minimize pelvic floor descent. This is a prospective study which evaluates the position of the pelvic floor during defaecation straining in 52 patients. The position of the perineum was measured at rest and during maximal defaecation straining using a perineometer, with the patient in the left lateral, sitting and squatting positions. There was a significant difference in the position of the perineum at rest and on straining between the left lateral position and both the sitting and squatting positions. However, there was no significant difference at rest or on straining between the sitting and squatting positions. These results show that squatting does not reduce pelvic floor descent during defaecation straining, and imply that squatting would not help reverse stretch-induced pudendal nerve damage.
Lam
T C
TC
Colorectal Unit, St George Hospital, Kogarah, Sydney, Australia.
Islam
N
N
Lubowski
D Z
DZ
King
D W
DW
D003672:Defecation; D005242:Fecal Incontinence / Q000503:physiopathology*; D006801:Humans; D009420:Nervous System / Q000503:physiopathology; D017773:Pelvic Floor / Q000503:physiopathology*; D010388:Pelvis / Q000294:innervation; D010502:Perineum / Q000503:physiopathology*; D011187:Posture; D011446:Prospective Studies; D020196:Trauma, Nervous System