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Published in: International Journal of Colorectal Disease 3/2018

01-03-2018 | Original Article

Pudendal nerve terminal motor latency testing does not provide useful information in guiding therapy for fecal incontinence

Authors: Julia T. Saraidaridis, George Molina, Lieba R. Savit, Holly Milch, Tiffany Mei, Samantha Chin, James Kuo, Liliana Bordeianou

Published in: International Journal of Colorectal Disease | Issue 3/2018

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Abstract

Purpose

Pudendal nerve terminal motor latency (PNTML) testing is a standard recommendation for the evaluation of fecal incontinence. Its role in guiding therapy for fecal incontinence has been previously questioned. The aim of this study was to evaluate the relationship between PNTML testing and anorectal dysfunction.

Methods

This was a retrospective analysis of data collected prospectively from patients who presented to a pelvic floor disorder center from 2007 to 2015. The relationship between PNTML (normal versus delayed) and anorectal manometry, fecal incontinence severity, and fecal incontinence-related quality of life scores was assessed using the Wilcoxon-Mann-Whitney test.

Results

Two hundred sixty-nine patients underwent PNTML testing, and 91.1% were female (N = 245) (median age 62.2 years). Normal PNTML was seen in 234 (87.0%) patients. Among 268 patients who underwent anorectal manometry, delayed PNTML was only significantly associated with median maximum anal squeeze pressure (P = 0.04). Delayed PNTML was not associated with a decrease in median fecal incontinence severity or fecal incontinence-related quality of life scores (N = 99).

Conclusions

PNTML was only associated with median maximum anal squeeze pressure, and it was not associated with patient-reported severity of symptoms of fecal incontinence, changes in quality of life attributable to fecal incontinence, median mean resting anal pressure, or median maximum resting anal pressure. PNTML testing may not be relevant to current therapeutic algorithms for fecal incontinence and its routine use should be questioned.
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Metadata
Title
Pudendal nerve terminal motor latency testing does not provide useful information in guiding therapy for fecal incontinence
Authors
Julia T. Saraidaridis
George Molina
Lieba R. Savit
Holly Milch
Tiffany Mei
Samantha Chin
James Kuo
Liliana Bordeianou
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 3/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-017-2959-5

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