Perineal Nerve Damage in Genuine Stress Urinary Incontinence; An Electrophysiological Study
British Journal of UrologyPublished 1 August 1985
S. J. Snooks, D. F. BADENOCH, R. C. Tiptaft, Michael Swash
Citations227
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TL;DR
Patients with genuine stress incontinence of urine were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle which may have implications regarding selection of patients for surgery to restore urethral competence.
Abstract
Twelve patients with genuine stress incontinence of urine were investigated using manometric and electrophysiological techniques. All were shown to have slowed conduction in the perineal branch of the pudendal nerve which innervates the periurethral striated sphincter muscle. The mean perineal nerve terminal motor latency in these patients was 3.9 +/- 0.8 (ms) and in 20 age and parity matched control subjects was 2.0 +/- 0.2 (ms) (P less than 0.001). These results are consistent with a neurogenic factor in patients with genuine stress incontinence of urine which may have implications regarding selection of patients for surgery to restore urethral competence.
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.
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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.
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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.
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The LancetSCOPE OF A TECHNIQUE FOR ELECTRICAL STIMULATION OF HUMAN BRAIN, SPINAL CORD, AND MUSCLE
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Brief high-voltage electrical shocks from a special low-output-resistance stimulator, delivered through electrodes on the skin, can excite human muscle directly (not by way of the nerves) and can also excite the motor cortex, the visual cortex, and the spinal cord.
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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.
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282 Citations1979Erik Stålberg
With the use of this greatly refined technique the knowledge of the electrical behaviour of individual muscle fibres, of the motor end-plate, and of the intramuscular nerve tree, has been and is being greatly increased.
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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.
Journal of Neurology Neurosurgery & PsychiatryDamage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence: an electrophysiological study.
174 Citations1984S. J. Snooks, P R Barnes +1 more
Results provide direct electrophysiological evidence of damage to the innervation of the pelvic floor musculature in idiopathic faecal and double incontinence, and imply that idiopathsic stress urinary incontinent may have a similar cause.
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.
Obstetrics and GynecologyClinical and Urodynamic Features of Failed Incontinence Surgery in the Female
133 Citations1978Stuart L. Stanton, Linda Cardozo +3 more
Factors which were associated with failed surgery included increaseing age, previous continence surgery, the presence of detrusor instability, and a postoperative rise of intrinsic bladder pressure either on filling of standing up.
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.
BJOG An International Journal of Obstetrics & GynaecologyA neurogenic element to urinary genuine stress incontinence
80 Citations1984Robert S. Anderson
The motor unit fibre density in the external anal sphincter has been measured and it is suggested that denervation is an aetiological factor in genuine stress incontinence and imply synchronous denervation of the pelvic floor muscles.
British Journal of UrologyPerineal Nerve and Transcutaneous Spinal Stimulation: New Methods for Investigation of the Urethral Striated Sphincter Musculature
55 Citations1984S. J. Snooks, Michael Swash
The distal motor latencies in the perineal and pudendal nerves were measured and transcutaneous spinal stimulation was used to record the motor latency from L1 and L4 stimulation sites to the urethral striated sphincter musculature.