Pathophsiological Study on Terminal Motor Latency in the Pudendal Nerve for Ulcerative Colitis after Ileal J Pouch-Anal Anastomosis with or without Soiling

Ryouichi Tomita¹⁾²⁾, Tarou Ikeda¹⁾, Shigeru Fujisaki¹⁾, Eichi Park¹⁾, Katuhisa Tanjoh¹⁾ and Masahiro Fukuzawa¹⁾

¹⁾First Department of Surgery, Nihon University School of Medicine ²⁾Department of Surgery, Nippon Dental University

Fifteen patients with uldcerative colitis after total colectomy, mucosal proctectomy, and ileal J pouch-anal anastomosis were neurophysiologically studied and compared with 16 healthy controls (A group; 10 men and 6 women, aged 18∼50 years with a mean age of 38.9 years). All of 15 patients (10 men and 5 women, aged 22∼57 years with a mean age of 40.2 years) were divided into 3 groups (Group B; 5 patients without soiling, Group C; 5 patients with soiling at watery diarrhea, Group D; 5 patients with soiling every day). The latency of response in the external anal sphincter muscle following digitally directed transrectal pudendal nerves (pudendal nerve terminal motor latency; PNTML) was measured. Following results were obtained. 1) The conduction delay of bilateral PNTML was signifivantly longer in group D than that in group A, B, and C (p<0.01, respectively). 2) The conduction delay of bilateral PNTML was significantly longer in group C than that in group A and B (p<0.05, respectively). 3) The conduction delay of bilateral PNTML in group B was longer than that in group A. But there was no significant difference between the group A and B. These findings support the hypothesis that the conduction delay of PNTML in the patients with UC may be caused by surgical demage to pudendal nerves. The degree of the conduction delay of bilateral PNTML correlated well with the symptom of soiling.

Key words
ulcerative colitis, ileal J puch-anal anastomosis, pudendal nerve motor terminal latency, soiling, pathophysiology

Reprint requests
Ryouichi Tomita Department of Sugery, Nippon Dental University 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, JAPAN

Accepted
June 26, 2001

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