Faecal incontinence due to external anal sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature: a double pathology
BJOG An International Journal of Obstetrics & GynaecologyPublished 1 August 1985
S. J. Snooks, M M Henry, Michael Swash
Citations189
SJR quartileQ1
SJR score1.79
SNIP1.92
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TL;DR
This finding suggests that damage to the innervation of the external anal sphincter often co‐exists with direct injury to the muscle; in these patients pelvic floor surgery may be required, in addition to spHincter repair itself.
Abstract
The commonest cause of external anal sphincter division is injury during childbirth. We have studied 20 patients with anterior external anal sphincter division using physical and electrophysiological techniques. There was evidence of pudendal nerve damage in 60% of these patients. This finding suggests that damage to the innervation of the external anal sphincter often co-exists with direct injury to the muscle; in these patients pelvic floor surgery may be required, in addition to sphincter repair itself.
Keywords
Medicine
The LancetINJURY TO INNERVATION OF PELVIC FLOOR SPHINCTER MUSCULATURE IN CHILDBIRTH
851 Citations1984S. J. Snooks, Michael Swash +2 more
The results of the study suggest that in most cases this incontinence results from damage to the innervation of the pelvic floor muscles.
GutSphincter denervation in anorectal incontinence and rectal prolapse.
552 Citations1977A G Parks, Michael Swash +1 more
It is suggested that idiopathic anorectal incontinence may be the result of denervation of the muscles of the anorak, and of the anal sphincter mechanism, which could result from entrapment or stretch injury of the pudendal or perineal nerves occurring as a consequence of rectal descent induced during repeated defaecation straining.
British journal of surgerySlowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence
497 Citations1984E S Kiff, Michael Swash
The hypothesis that idiopathic (neurogenic) faecal incontinence is due to damage to the nerve supply of the pelvic floor musculature is supported.
British journal of surgeryPhysiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse
333 Citations1981M. Neill, A G Parks +1 more
Investigations imply that denervation of the sphincter musculature can be recognized by electrophysiological tests in most patients with primary faecal incontinence and that the pathogenesis of rectal prolapse differed in the two groups of patients.
British journal of surgeryThe pelvic floor musculature in the descending perineum syndrome
328 Citations1982M M Henry, A G Parks +1 more
Journal of Neurology Neurosurgery & PsychiatryIncreased motor unit fibre density in the external anal sphincter muscle in ano-rectal incontinence: a single fibre EMG study.
288 Citations1980M. Neill, Michael Swash
The motor unit fibre density in the external anal sphincter muscle has been measured and provides support for the suggestion that ano-rectal incontinence commonly has a neurogenic basis.
British journal of surgeryPostanal repair for neuropathic faecal incontinence: Correlation of clinical result and anal canal pressures
221 Citations1983Gavin Browning, A G Parks
The results show that postanal repair effectively lengthens the anal canal and increases anal pressures in patients with a successful clinical outcome.
Journal of the Neurological SciencesPathogenesis of ano-rectal incontinence
211 Citations1979F. Beersiek, A G Parks +1 more
Type 1 fibre predominance was found in the external anal sphincter, puborectalis and levator ani muscles of 17 control subjects and of 16 patients with ano-rectal incontinence.
Journal of Neurology Neurosurgery & PsychiatryElectroejaculation: its technique, neurological implications and uses.
189 Citations1981G. S. Brindley
An improved technique for electroejaculation is described, with the results of applying it to 84 men with spinal injuries and five men with ejaculatory failure from other causes.
GutAnorectal incontinence and rectal prolapse: differential assessment of the innervation to puborectalis and external anal sphincter muscles.
138 Citations1985S. J. Snooks, M M Henry +1 more
Data show that the different innervations of the puborectalis and external anal sphincter muscles are both damaged in patients with anorectal incontinence.
British Journal of UrologyAbnormalities of the Innervation of the Urethral Striated Sphincter Musculature in Incontinence
131 Citations1984S. J. Snooks, Michael Swash
There was evidence of both a distal (perineal nerve) and a proximal (sacral root) component to the damage to the nerve supply of the urethral striated sphincter muscle in half of the patients.
BMJResults of Parks operation for faecal incontinence after anal sphincter injury.
58 Citations1983Gavin Browning, R W Motson
The results show that even after severe injury to the sphincters surgical reconstruction can restore continence in most patients.