By Eamonn M.M. Quigley MD FRCP FACP FACG FRCPI
Gastroenterology Clinics of North the US updates you at the most up-to-date developments in sufferer administration; retains you modern at the most modern advances; and offers a legitimate foundation for selecting therapies. each one factor specializes in a unmarried subject in gastroenterology and is gifted lower than the path of an skilled visitor editor.
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These nerves are inhibited during voiding. In contrast, parasympathetic (sacral) nerves cause the detrusor muscle to contract and are stimulated during micturition. The somatic nervous system controls the striated external urethral sphincter and levator ani muscle through the pudendal nerve and the sacral nerve roots (S2–S4). Inhibition of these nerves causes relaxation of the bladder outlet and pelvic floor, which must occur during voiding. The central nervous system provides voluntary control and modification of micturition reflexes.
103 Measurements and clinical use The recorded latency primarily reflects integrity of myelin insulation of the nerve, but may also indicate damage to the largest and fastest conducting fibers. A prolonged latency indicates either demyelination103 or irreparable damage of a number of fast 527 528 Scott & Gladman firing fibers. 52,105,107 The normal upper limit for latency, which is a continuous variable, not a dichotomous one, has been illdefined for a robust diagnosis of pudendal neuropathy. 116,117 There are also a number of concerns related to methodology and interpretation: 1.
130. 131. 132. response to biofeedback therapy in fecal incontinence. Dis Colon Rectum 1999; 42(6):762–9. Gilliland R, Altomare DF, Moreira H Jr, et al. Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 1998; 41(12):1516–22. Thomas C, Lefaucheur JP, Galula G, et al. Respective value of pudendal nerve terminal motor latency and anal sphincter electromyography in neurogenic fecal incontinence. Neurophysiol Clin 2002;32(1):85–90. Gregory WT, Lou JS, Stuyvesant A, et al.