Abstract
Objectives: The objective of our study was to analyse the impact of pudendal nerve terminal motor latency (PNTML) testing on the final treatment procedure in a group of patients who presented to us with anorectal disorders. Methods: The PNTML results and the final treatment procedure of 24 patients who attended the gastrointestinal physiology laboratory in the Department of Surgery at the University of Colombo was analysed. Results: Male to female ratio was 6 : 18 (1 : 3). The study population had a median age of 28 years with a range of 13 years to 69 years. The indications for the study were recurrent fistulain- ano 8 (33%), anal sphincter trauma 6 (25%), rectal prolapse 5 (21%), idiopathic incontinence 3 (13%) and miscellaneous 2 (8%). Twelve patients (50%) indicated bilateral or unilateral abnormality. Only in 4 (17%) patients, the final treatment modality was changed as a result of PNTML report. Conclusion: Although a significant number of patients (50%) indicated an abnormality in their PNTML values, it was of limited value in deciding the final treatment modality. doi: 10.4038/gmj.v11i1.1108 Galle Medical Journal Vol.11(1) 2006 3-6
Highlights
External anal sphincter (EAS) weakness leading to anal incontinence can occur either due to anatomical separation of the EAS muscles or pudendal nerve injury
Kiff and Swash in 1984 described a technique to measure the pudendal nerve terminal motor latency (PNTML) and demonstrated that some patients with idiopathic faecal incontinence had a neuropathy affecting the terminal portion of the pudendal nerve [2]
Regardless of how the external anal sphincter is subdivided by numerous anatomists and clinicians, on electromyography, it appears that the striated muscles of the anorectal sphincter complex are acting as one unit [7]
Summary
External anal sphincter (EAS) weakness leading to anal incontinence can occur either due to anatomical separation of the EAS muscles or pudendal nerve injury. Kiff and Swash in 1984 described a technique to measure the pudendal nerve terminal motor latency (PNTML) and demonstrated that some patients with idiopathic faecal incontinence had a neuropathy affecting the terminal portion of the pudendal nerve [2]. Their technique was based on electro ejaculation procedure developed by Brindley for people with spinal cord injuries and this same technique was modified to invent the present manoeuvre that is used to assess the PNTML [3]. At present there is a debate regarding the validity of PNTML in the management of anal sphincter dysfunction. Some studies have indicated that PNTML helps but others have indicated PNTML was not predictive of final outcome of surgery [2,4,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
