Publication

The puborectal continence reflex functions independently of the pudendal nerve

Jonker, J. E., van Meegdenburg, M. M., Trzpis, M. & Broens, P. M. A., Nov-2019, In : Colorectal Disease. 21, 11, 8 p.

Research output: Contribution to journalArticleAcademicpeer-review

Aim The ability of patients with poor pudendal nerve function to voluntarily contract their external anal sphincter is limited. However, it is not known whether the condition of the pudendal nerve influences voluntary puborectal muscle contraction. Recently, we described the puborectal continence reflex that maintains faecal continence by involuntary contractions of the puborectal muscle. We aim to investigate whether both voluntary and involuntary contractions of the puborectal muscle are influenced by the condition of the pudendal nerve. Method We retrospectively analysed 129 adult patients who underwent anorectal function tests at the Anorectal Physiology Laboratory. Anal electrosensitivity was used as a measurement of the pudendal nerve function. Voluntary and involuntary contractions of the puborectal muscle were defined as maximum puborectal muscle contractility and maximum pressure at the level of the puborectal muscle during the balloon retention test. Results Voluntary contraction of the puborectal muscle was significantly decreased in patients with pudendal nerve damage (P = 0.002). Involuntary contractions, however, were not associated with the condition of the pudendal nerve (P = 0.63). Multiple linear regression analysis showed that the condition of the pudendal nerve and patients' sex significantly predicted voluntary contraction but not involuntary contraction. Conclusion Voluntary contractions of the puborectal muscle are significantly decreased in patients with pudendal nerve damage, while involuntary contractions of the puborectal muscle are comparable to those of patients without nerve damage. We conclude that the puborectal continence reflex, which controls involuntary contractions of the puborectal muscle, is not regulated by the pudendal nerve.

Original languageEnglish
Number of pages8
JournalColorectal Disease
Volume21
Issue number11
Publication statusPublished - Nov-2019

    Keywords

  • Fecal incontinence, puborectal continence reflex, pudendal nerve, fecal continence, puborectal muscle, anorectal manometry, FECAL INCONTINENCE, ANAL SENSATION, INNERVATION, CONSTIPATION, NEUROPATHY, ANATOMY

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