대한대장항문학회

Purpose: This study was undertaken to identify factors influencing fecal incontinence in rectal prolapse.<br>Methods: The clinical and anorectal physiologic data (anal manometry, rectal sensitivity test, pudendal nerve terminal motor latency (PNTML)) of 42 complete rectal prolapse patients were collected in a prospective database and were analyzed<br>according to<br>Wexner's incontinence score (0-20).<br>Results: The mean Wexner's incontinence score was 10.6. Females (n=24) were more prone to be incontinent than males (n=18)(incontinence score 14.8 vs 5.1, p＜0.001). A linear regression analysis showed that increased age (r= 0.497, p=0.001),<br>decreased<br>maximum resting pressure (MRP) (r= 0.686, p＜0.001), decreased maximum squeezing pressure (MSP)(r= 0.789, p＜0.001), decreased maximal rectal tolerable volume (MTV) (r= 0.386, p=0.012) influenced the incontinence score. An absent rectoanal<br>inhibitory<br>reflex (RAIR) was not related to incontinence, but was related to significantly low resting anal pressure. Delayed PNTML did not influence incontinence or the MSP. In a multiple regression analysis, decreased MRP (β= 0.383; p=0.002), decreased<br>MSP<br>(β=<br>0.345; p =0.007) and female gender (β=0.343; p=0.006) influenced incontinence significantly.<br>Conclusions: Major factors influencing fecal incontinence in complete rectal prolapse were decreased MRP and MSP. Female patients were more prone to fecal incontinence than males. RAIR and MTV were not significant factors. PNTML did not show any<br>relation to incontinence score or the anal pressure.<br>