DOES SQUATTING REDUCE PELVIC FLOOR DESCENT DURING DEFECATION

Neurogenic faecal and urinary incontinence result from a stretch-induc ed injury to the pelvic nerves, from difficult childbirth or from chro nic straining at stool. It has been suggested that the condition occur s less frequently in societies where the squatting position is used du ring defaecation, and that squatting may minimize pelvic floor descent . This is a prospective study which evaluates the position of the pelv ic floor during defaecation straining in 52 patients. The position of the perineum was measured at rest and during maximal defaecation strai ning using a perineometer, with the patient in the left lateral, sitti ng and squatting positions. There was a significant difference in the position of the perineum at rest and on straining between the left lat eral position and both the sitting and squatting positions. However, t here was no significant difference at rest or on straining between the sitting and squatting positions. These results show that squatting do es not reduce pelvic floor descent during defaecation straining, and i mply that squatting would not help reverse stretch-induced pudendal ne rve damage.