Abstract
Pelvic floor disorders (Table 1) are a common cause of disability and distress often resulting in faecal incontinence especially in women, but hitherto their pathogenesis has not been well understood. We have found that these disorders are associated, in varying degree, with clinical, electrophysiological and histological features of chronic partial denervation in the muscles of the pelvic floor, especially in the puborectalis and levator ani muscles, and in the external anal and periurethral striated sphincter muscles [1–7]. These studies have led us to develop a unifying approach to understanding the pathogenesis of this group of disorders that has implications for diagnosis, investigation and management, and also for prevention.
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References
Parks AG, Swash M, Urich H. 1977. Sphincter denervation in ano-rectal incontinence and rectal prolapse. Gut 18: 656–665.
Neill ME, Swash M. 1980. Increased motor unit fibre density in the external anal sphincter muscle in ano-rectal incontinence; a single fibre EMG study. J Neurol Neurosurg Psych 43: 343–347.
Snooks SJ, Henry MM, Swash M. 1985. Ano-rectal incontinence and rectal prolapse; differential assessment of the puborectalis and external anal sphincter muscles. Gut 26:470–477.
Snooks SJ, Henry MM, Swash M. 1985. Abnormalities in central and peripheral nerve conduction in ano-rectal incontinence. J Roy Soc Med 78: 294–300.
Beersiek F, Parks AG, Swash M. 1979. Pathogenesis of pelvic floor disorders; a histometric study of the anal sphincter musculature. J Neurol Sci 42:111–127.
Snooks SJ, Barnes PRH, Swash M. 1984. Damage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence; an electrophysiological study. J Neurol Neurosurg Psychiatry 47:1269–1273.
Snooks SJ, Swash M. 1984. Abnormalities of the urethral striated sphincter musculature in incontinence. Br J Urol 56: 401–405.
Snooks SJ, Barnes PRH, Swash M, Henry MM. 1985. Damage to the innervation of the pelvic floor musculature in chronic constipation. Gastroenterology 89: 977–981.
Preston DM, Lennard-Jones JE. 1985. Anismus in chronic constipation. Dig Dis Sci 30: 413–418.
Snooks SJ, Swash M. 1986. Slowed motor conduction in the lumbosacral nerve roots in cauda equina lesions. J Neurol Neuro Surg Psych 49: 808–816.
Beck A. 1930. Electromyographische Untersuchungen am sphincter ani. Pfugers Arch Ges Physiol 224: 278.
Floyd WD, Walls EW. 1953. Electromyography of the sphincter ani externus in man. Journal of Physiology, London 122: 599–609.
Buchtal F. 1960. The general concept of the motor unit. Res Publ Ass Nerv Ment Dis 38: 3.
Parks AG, Porter NH, Hardcastle J. 1966. The syndrome of the descending perineum. Proc Roy Soc Med 59: 477–482.
Kerremans R. 1969. Morphological and physiological aspectsof anal continence and defaecation. Editions Arscia, Brussels.
Porter NH. 1962. A physiological study of the pelvic floor in rectal prolapse. Ann Roy Coll Surg Engl 31: 379–401.
Bartolo DCC, Jarratt JA, Read MG, Donnelly TC, Read NW. 1983. The role of partial denervation of the puborectalis in idiopathic faecal incontinence. Br J Surg 70: 664–667.
Stalberg E, Trontelj JV. 1979. Single fibre electromyography. Old Woking, Surrey, UK. The Mirralle Press Ltd: 64.
Swash M, Schwartz MS. 1984. Implications of longitudinal fibre splitting in neurogenic and myopathic disorders. Springer-Verlag, London: 350.
Stalberg E, Thiele B. 1975. Motor unit fibre density in the extensor digitorum communis muscle. J Neurol Neurosurg Psych 38: 874–880.
Merton PA, Hill DK, Morton HB, Marsden CD. 1982. Scope of a technique for electrical stimulation of human brain, spinal cord and muscle. Lancet i: 597–600.
Percy JP, Neill ME, Swash M, Parks AG. 1981. Electrophysiological study of motor nerve supply of pelvic floor. Lancet i: 16–17.
Brindley GS. 1981. Electroejaculation: its technique, neurological implications and use. Neurol Neurosurg Psych 44: 9–18.
Kiff ES, Swash M. 1984. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg 71: 614–616.
Henry MM, Parks AG, Swash M. 1982. The pelvic floor musculature in the descending perineum syndrome. Br J Surg 69: 470–472.
Henry MM, Swash M. 1985. Coloproctology and the Pelvic Floor. Butterworths. London.
Snooks SJ, Badenoch D, Tiptaft R, Swash M. 1985. Perineal nerve damage in genuine stress urinary incontinence; an electrophysiological study. Br J Urol 57: 422–426.
Parks AG. 1975. Ano-rectal incontinence. Proc Roy Soc Med 68: 681–690.
Snooks SJ, Swash M, Setchell M, Henry MM. 1984. Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet ii: 546–550.
Snooks SJ, Henry MM, Swash M. 1985. Obstetric sphincter division and pudendal nerve damage; a double lesion. Br J Obstet Gynaecol. In press.
Neill ME, Parks AG, Swash M. 1981. Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse. Br J Surg 68: 531–536.
Polgar J, Johnson M, Weightman D, Appleton D. 1973. Data on fibre size in thirty-six human muscles; an autopsy study. J Neurol Sci 19: 307–318.
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© 1987 Martinus Nijhoff Publishers, Dordrecht
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Snooks, S.J., Swash, M. (1987). Electromyography and nerve latency studies. In: Gooszen, H.G., Ten Cate Hoedemaker, H.O., Weterman, I.T., Keighley, M.R.B. (eds) Disordered Defaecation. Developments In Surgery, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-3335-4_2
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DOI: https://doi.org/10.1007/978-94-009-3335-4_2
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