POST-SURGICAL OR TRAUMATIC FECAL INCONTIN ENCE - ULTRASONOGRAPHIC ANDELECTROMYOGRAPHIC ANORECTAL ASSESSMENT IN 40 PATIENTS

Objectives. - Anal endosonography is used to assess anal canal structu re and external anal sphincter. The purpose of this study was to compa re findings at anal endosonography with electromyographic tests in pat ients with faecal incontinence. Methods. - Fourty patients (31 women; median age: 47 years) were referred for exploration of the anal sphinc ter: 15 patients had previous anal surgery, 16 patients had obstetrica l trauma, 3 patients had accidental trauma, 6 women had obstetrical tr auma and previous anal surgery. Results. - Anal endosonography demonst rated an external sphincter defect in 19 patients (partial n = 4, comp lete n = 15); 18 of these patients had an electromyographic study: an external sphincter defect was demonstrated by mapping in 15 cases; 3 p artial defects were nor found. Eight patients had associated pudendal nerve terminal motor latency delayed due to neuropathic impairment of pundendal nerve. Surgery,vas performed in 12 patients; external sphinc ter lesion was confirmed in all cases. Conclusions. - Anal endosonogra phy and electromyography mapping easily recognize external sphincter d isruption with high concordance. Partial defects are better diagnosed by anal endosonography. A study of pudendal nerve terminal motor laten cy is useful in the exploration of faecal incontinence because pudenda l neuropathy occurs frequently in association with a sphincter defect.