Anal mucosal electric sensation in postoperative patients with anorectal malformations.
BACKGROUND
No previous report has, to our knowledge, been made on anal mucosal electric sensation in postoperative patients with anorectal malformations (ARMs). We studied the anal mucosal electric sensory threshold (AMEST) in comparison with clinical manifestation.


METHODS
The study included 25 patients with ARMs who underwent anorectoplasty (ARMs group) and 10 subjects (control group). Based on the type of ARMs, patients were divided into 3 subgroups: high type, n = 14; intermediate type, n = 6; low type, n = 5. The AMEST was measured at 3 positions, at the anal skin margin and 1 and 2 cm from the anal skin margin. The AMEST was analyzed compared with the type of ARMs and clinical manifestation.


RESULTS
The AMEST clearly increased at the 3 sites in patients with ARMs, especially those with high and intermediate types, compared with control subjects. The sensitivity threshold in the lower anal canal in the low-type subgroup was about the same as that in the control group. An analysis of clinical manifestations showed significantly increased thresholds in the upper and middle anal canal in the group of patients with difficulty in discriminating between gas and defecation and with fecal incontinence (P < .01 and P < .05).


CONCLUSIONS
The AMEST for the high-type and intermediate-type subgroups in the ARMs group was worse than that in the low-type subgroup and control group. The AMEST in the upper and middle anal canal was important for gas and defecation distinction and fecal maintenance.
Ikeda
Taro
T
Division of Pediatric Surgery, Department of Surgery, Nihon University School of Medicine, Tokyo 173-0032, Japan. taroi@med.nihon-u.ac.jp
Tomita
Ryouichi
R
Koshinaga
Tsugumichi
T
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003672:Defecation; D004558:Electric Stimulation; D005242:Fecal Incontinence; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D012007:Rectum / Q000002:abnormalities* / Q000601:surgery