완전 직장탈 환자에서 변실금에 영향을 미치는 인자
Factors Influencing Fecal Incontinence in Complete Rectal Prolapse - A Prospective Analysis
윤서구, 이광렬, 김건욱, 송석규, 김칠석, 이종균, 김광연,
소속 상세정보
윤서구 ( Yoon Seo-Gu )
송도병원 외과
이광렬 ( Lee Kwang-Ryul )
송도병원 외과
김건욱 ( Kim Khun-Uk )
송도병원 외과
송석규 ( Song Suk-Kyu )
송도병원 외과
김칠석 ( Kim Chil-Seok )
송도병원 외과
이종균 ( Lee Jong-Kyun )
송도병원 외과
김광연 ( Kim Kwang-Yeon )
송도병원 외과
KMID : 0356720010170010007
Abstract
Purpose: This study was undertaken to identify factors influencing fecal incontinence in rectal prolapse.
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 according to Wexner’s incontinence score (0-20).
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), decreased 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 inhibitory 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 MSP (β= 0.345; p =0.007) and female gender (β=0.343; p=0.006) influenced incontinence significantly.
Conclusion: 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 relation to incontinence score or the anal pressure.
키워드
직장탈;변실금;항문내압검사;음부신경 말단운동근 잠복기검사
Rectal prolapse;Fecal incontinence;Anal manometry;PNTML
원문 및 링크아웃 정보
등재저널 정보