title: Neurological function of the puborectalis muscle in patients with or without soiling after ileal J-pouch-anal anastomosis for ulcerative colitis in childhood.
abstract: BACKGROUND
  To clarify the puborectalis muscle (PM) function in pediatric patients with soiling after ileal J-pouch-anal anastomosis (IPAA) for ulcerative colitis, the author examined the neurological functions of the PM.
  
  
  METHODS
  Twelve patients 3 months after IPAA were studied (average age 13.6 years). Five patients showed soiling every day (group A1) and 7 patients showed soiling 2 to 3 days per week (Group A2). All patients 1.5 years after IPAA showed continence (group B). Twenty subjects served as a control (Group C; average age 13.5 years). Right, left and posterior sides of the sacral nerve terminal motor latency (SNTML) were measured by magnetic stimulation.
  
  
  RESULTS
  On the right, left and posterior sides, patients in group A1 exhibited significant prolongation of the SNTML compared with patients in groups A2, B and C (P<.05 each). Group A2 exhibited significant prolongation compared with groups B and C (P<.05 each). There were no significant differences of the SNTML between right and left sides, between right and posterior sides and between left and posterior sides in groups A1, A2, B and C.
  
  
  CONCLUSIONS
  The SNTML of the PM demonstrates significant latency in those children who have early post-IPAA soilage. The neurological function of the PM potentially injured during an operation may recover, and correlates with normalization of continence.
authors.affiliation: Department of Surgery, Nippon Dental University School of Life Dentistry, Tokyo 173-0032, Japan; Department of Surgery, Nihon University School of Medicine, Tokyo 173-0032, Japan. Electronic address: rtomita@tky.ndu.ac.jp.
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000294:innervation / Q000601:surgery*; D003093:Colitis, Ulcerative / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D039021:Colonic Pouches / Q000294:innervation*; D003672:Defecation / Q000502:physiology*; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009130:Muscle, Smooth / Q000294:innervation / Q000503:physiopathology*; D020127:Recovery of Function
keywords: Childhood; Puborectalis muscle; Sacral nerve terminal motor latency; Soiling; Ulcerative colitis