대한대장항문학회

Purpose : The pathophysiology of pediatric encopresis has been incomprehensible. The<br>current study was designed to assess its clinical and physiologic findings. Moreover,<br>outcome of treatment was evaluated. Methods : The clinical and functional findings of<br>18 patients (13 boys, 5 girls) were analyzed, retrospectively. Physiololgic studies for<br>cooperative child included anal manometry (n=12), cinedefecography (n=3), and PNTML<br>(pudendal nerve terminal motor latency, n=1). For exclusion of the organic cause, barium<br>contrast study was carried out in all case. Patients were categorized by leading<br>symptom as constipation or incontinence. Physiologic findings and outcome of treatment<br>were analyzed based on the categorized groups. Biofeedback therapy by using<br>newly-developed anal sphinter control system (KONTINENCE<br>CLINICAL<sup>TM</sup> ) in my institute, was underwent a mean 4.1(range, 2∼12)<br>sessions. The outcome was analyzed in the period of 5.4 (range, 1∼33) months follow<br>-up. Results : Patients were categorized as having constipation (groupⅠ, n=12) of<br>incontinence (groupⅡ, n=6) group. In the manometric parameters, there were no<br>statistical differences between the values of the mean resting pressure (RP), the<br>maximum RP, and the maximum voluntary contraction between group Ⅰand Ⅱ. In the<br>cinedefecography, 3 of group Ⅰpatients revealed as having the pelvic floor dyssynergia.<br>The finding of PNTML were not specific in groupsⅡ(n=1) . Regarding to the<br>therapeutic outcome, 8 of 10 patients were cured or improved. Conclusions : There were<br>no differences in the resting and squeeze profile of manometric parameters between two<br>proups. However, pelvic floor dyssynergia was identified in the cinedefecography of<br>constipated group. Conventional and biofeedback treatment for encopretic children<br>provides acceptable outcome.<br>