title: Clinical and instrumental parameters in patients with constipation and incontinence: their potential implications in the functional aspects of these disorders.
abstract: OBJECTIVE
  The aims of this study were to evaluate several clinical and instrumental parameters in a large number of patients with constipation and incontinence as well as in healthy controls and discuss their potential implications in the functional aspects of these disorders.
  
  
  METHODS
  Eighty-four constipated and 38 incontinent patients and 45 healthy controls were submitted to a protocol based on proctologic examination, clinico-physiatric assessment, and instrumental evaluation.
  
  
  RESULTS
  Constipated and incontinent patients had significantly worse lumbar lordosis as well as lower rate in the presence of perineal defense reflex than controls. Constipated but not incontinent patients had a lower rate of puborectalis relaxation than controls. Furthermore, worse pubococcygeal tests and a higher rate of muscle synergies presence, either agonist or antagonist, were observed in both constipated and incontinent patients compared to controls.
  
  
  CONCLUSIONS
  This study has demonstrated strong correlations between physiatric disorders and the symptoms of constipation and incontinence. Further studies designed to demonstrate a causal relationship between these parameters and the success of a specific treatment of the physiatric disorders on the proctology symptoms are warranted.
authors.affiliation: First Division of General and Gastrointestinal Surgery, Second University of Naples, Naples, Italy. luigibrusciano@tin.it
authors.forename: L
authors.initials: L
authors.lastname: Brusciano
authors.forename: P
authors.initials: P
authors.lastname: Limongelli
authors.forename: G
authors.initials: G
authors.lastname: del Genio
authors.forename: G
authors.initials: G
authors.lastname: Rossetti
authors.forename: S
authors.initials: S
authors.lastname: Sansone
authors.forename: A
authors.initials: A
authors.lastname: Healey
authors.forename: V
authors.initials: V
authors.lastname: Maffettone
authors.forename: V
authors.initials: V
authors.lastname: Napolitano
authors.forename: F
authors.initials: F
authors.lastname: Pizza
authors.forename: S
authors.initials: S
authors.lastname: Tolone
authors.forename: A
authors.initials: A
authors.lastname: del Genio
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003248:Constipation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D003672:Defecation; D019841:Defecography; D003938:Diagnostic Techniques, Digestive System; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008141:Lordosis / Q000150:complications; D008159:Lumbar Vertebrae; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D018579:Patient Selection; D017773:Pelvic Floor / Q000503:physiopathology; D010810:Physical and Rehabilitation Medicine; D011237:Predictive Value of Tests; D012021:Reflex, Abnormal; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D055815:Young Adult