Neurological function of the puborectalis muscle in patients with or without soiling after ileal J-pouch-anal anastomosis for ulcerative colitis in childhood

Abstract

BackgroundTo clarify the puborectalis muscle (PM) function in pediatric patients with soiling after ileal J-pouch-anal anastomosis (IPAA) for ulcerative colitis, the author examined the neurological functions of the PM. MethodsTwelve patients 3months after IPAA were studied (average age 13.6years). Five patients showed soiling every day (group A1) and 7 patients showed soiling 2 to 3days per week (Group A2). All patients 1.5years after IPAA showed continence (group B). Twenty subjects served as a control (Group C; average age 13.5years). Right, left and posterior sides of the sacral nerve terminal motor latency (SNTML) were measured by magnetic stimulation. ResultsOn the right, left and posterior sides, patients in group A1 exhibited significant prolongation of the SNTML compared with patients in groups A2, B and C (P<.05 each). Group A2 exhibited significant prolongation compared with groups B and C (P<.05 each). There were no significant differences of the SNTML between right and left sides, between right and posterior sides and between left and posterior sides in groups A1, A2, B and C. ConclusionsThe SNTML of the PM demonstrates significant latency in those children who have early post-IPAA soilage. The neurological function of the PM potentially injured during an operation may recover, and correlates with normalization of continence.