Functional asymmetry of pelvic floor innervation and its role in the pathogenesis of fecal incontinence

Digestion

Volumn 69, Issue 2, 2004, Pages 102-111

  Enck, Paul ^a   Hinninghofen, Heidemarie ^a   Wietek, Beate ^a   Becker, Horst D ^a  

^a UNIVERSITY HOSPITAL TÜBINGEN   (Germany)

Author keywords

Asymmetry; Fecal incontinence; Innervation; Pathophysiology

Indexed keywords

CONTINENCE; FECES INCONTINENCE; HUMAN; INTRAOPERATIVE PERIOD; MOTOR UNIT POTENTIAL; MUSCLE INNERVATION; NERVE STIMULATION; NEUROPATHY; PATHOGENESIS; PATHOPHYSIOLOGY; PATIENT MONITORING; PELVIS FLOOR; PRIORITY JOURNAL; PUDENDAL NERVE; RECORDING; REVIEW;

ELECTRIC STIMULATION; ELECTROMYOGRAPHY; FECAL INCONTINENCE; FEMALE; HUMANS; MALE; MOTOR NEURONS; NEURONS, AFFERENT; PELVIC FLOOR; URINARY INCONTINENCE;

EID: 2642536745     PISSN: 00122823     EISSN: None     Source Type: Journal    
DOI: 10.1159/000077876     Document Type: Review

References (26)

1. Hinninghofen H, Enck P: Management of patients with fecal incontinence; in Mertz H (ed): Functional Gastrointestinal Disorders. Gastroenterol Clins N Am 2003;32:685-706.
2. Kiff ES, Swash M: Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg 1984;71:614-616.
3. Enck P, Herdmann J, Börgermann K, Theisen U, Zacchi P, Lübke HJ: Up and down the spinal cord: Afferent and efferent innervation of the external anal sphincter in humans. J Gastrointestinal Motility 1992;4:271-277.
4. Sangwan YP, Coller JA, Barrett RC, Roberts PL, Murray JJ, Rusin L, Schoetz DJ Jr: Unilateral pudendal neuropathy: Impact on outcome of anal sphincter repair. Dis Colon Rectum 1996;39:686-689.
5. Lubowski DZ, Jones PN, Swash M, Henry MM: Asymmetrical pudendal nerve damage in pelvic floor disorders. Int J Colorect Dis 1988;3:1598-1560.
6. Hamdy S, Aziz Q, Rothwell JC, Crone R, Hughes D, Tallis RC, Thompson DG: Explaining oropharyngeal dysphagia after unilateral hemispheric stroke. Lancet 1997;350:686-692.
7. Enck P, von Giesen HJ, Schäfer A, Heyer T, Gantke B, Flesch S, Arendt G, Schmitz N, Frieling T, Häussinger D: Comparison of anal sonography with conventional needle EMG to evaluate anal sphincter defects. Am J Gastroenterol 1996;91:2539-2543.
8. Deletis V, Vodusek DB, Abbott R, Epstein FJ, Turndorf H: Intra-operative monitoring of the dorsal sacral roots: Minimizing the risk of iatrogenic micturition disorders. Neurosurgery 1992;30:72-75.
9. Huang JC, Deletis V, Vodusek DB, Abbott R: Preservation of pudendal afferents in sacral rhizotomies. Neurosurgery 1997;41:411-415.
10. Krzan MJ, Kothbauer KF, Deletis V, Enck P, Abbott RI: Comparison of the radicular distribution of anal mucal and penile/clitorial afferents. Clin Neurophysiol 1999;110:2383.
11. Matzel KE, Stadelmaier U, Hohenfellner M, Dahms E, Hohenberger W, Enck P: Asymmetry of pudendal motor function assessed during intraoperative monitoring. Gastroenterology 1999;116:A1937.
12. Turnbull GK, Hamdy S, Aziz Q, Singh KD, Thompson DG: The cortical topography of human anorectal musculature. Gastroenterology 1999;117:32-39.
13. Witscher K, Greving I, Liepert J, Tegenthoff M, Enck P: A bihemispheric representation of the anal sphincter on the human motor cortex. Gastroenterology 1998;114:A1130.
14. Stottrop K, Schnitzler A, Witte OW, Freund HJ, Enck P: Cortical representation of the anal canal. Gastroenterology 1998;114:A167.
15. Hamdy S, Enck P, Aziz Q, Rothwell JC, Üngörgil S, Hobson A, Thompson DG: Spinal and pudendal nerve modulation of human corticoanal motor pathways. Am J Physiol 1998;274:G419-423.
16. Hamdy S, Enck P, Aziz Q, Üngörgil S, Hobson A, Thompson DG: Laterality effects of pudendal nerve stimulation on human cortico-anal pathways: Evidence for functional asymmetry. Gut 1999;45:58-63.
17. Middelsdorf P, von Giesen HJ, Schneider J, Musial F, Arendt G, Enck P: Extend of functional asymmetry of the external anal sphincter muscle in healthy volunteers. Neurogastroenterology 1998;10:439.
18. Wietek B, Hinninghofen H, Jehle EC, Franz H, Enck P: Traumatic childbirth, but not childbirth per se results in incontinence in case of asymmetric sphincter innervation. Gastroenterology 2002;122:A446.
19. Hinninghofen H, Wietek B, Enck P: Asymmetry of anal sphincter innervation is related to gender, incontinence, and childbirth. Neurogastroenterology 2003;15:90.
20. Enck P: Biofeedback training in disordered defecation: A critical review. Dig Dis Sci 1993;38:1953-1960.
21. Swash M: Electrophysiological investigation of the posterior pelvic floor musculature; in Pemberton JH, Swash M, Henry MM (eds): The pelvic floor - its funtion and disorders. London, Saunders, 2002, pp 213-236.
22. Merletti R, Roy SH, Kupa E, Roatta S, Granata A: Modeling of surface myoelectric signals. II. Model-based signal interpretation. IEEE Trans Biomed Eng 1999;46:821-829.
23. Merletti R, Farina D, Granata A: Non-invasive assessment of motor unit properties with linear electrode arrays. Electroencephalogr Clin Neurophysiol 1999;(suppl 50):293-300.
24. Hinninghofen H, Merletti R, Liu M, Wietek B, Enck P: Multi-electrode array surface EMG recording of single motor unit action potentials from the external anal sphincter. Gastroenterology 2002;122:A449.
25. Liu M, Hinninghofen H, Merletti R, Wietek B, Heesakkers J, Enck P: Surface electromyography of the anal and urethral sphincter: New insights with a new technique. Neurogastroenterology 2002;14:582f.
26. Merletti R, Bottin A, Hinninghofen H, Martina S, Franz H, Enck P: Detection of individual motor units of the external anal sphincter by surface EMG electrode arrays (in preparation).