In a prospective electromyographic and manometric study on 23 women (average age 52 years) with obstructive defecation disorder the activity of the external anal sphincter muscle and the puborectal muscle was investigated at rest and during contraction and straining. The control group consisted of 22 healthy women with an average age of 53 years. The main aim of the study was to investigate the functioning of the two muscles during simulated defecation (maximum strain) and to examine any changes in the pressure ratio in the rectum and the anal canal during this stimulation. There were no significant differences in the resting pressure, the contraction pressure and the straining pressure (in the rectum and the anal canal) between the two groups. The functioning of the puborectal muscle and the external anal sphincter muscle was largely the same in both the study group and the control group. No statistically significant differences were found between the two groups except in the amplitude of contraction. When we tried to list the change in the activity of the muscle as an index of anism, we were not able to objectify such a change for either the external anal sphincter muscle or the puborectal muscle. We therefore conclude that the increase in the activity of the voluntary muscle of the pelvic floor observed on electromyography during defecation does not indicate a pathologic condition but is a functional state.

Hemisensory impairment in patients with chronic nerve root irritation syndromes can indicate a functional disorder in dealing with noxious impulses in the ventral posterior nucleus of the thalamus. They represent a clinical correlative to subcortical neuroplasticity, which could explain the resistance to therapy in severe chronic pain syndromes.

This study was carried out to document the long-term results of postanal repair for idiopathic faecal incontinence. Thirty-one patients (mean age 65.6 years) were followed up for 2-7.5 years (median 4.2 years). Continence was improved in 16 (52%) patients, only 2 (6%) of whom regained normal continence. No significant change in resting anal pressure, maximum squeeze pressure, pelvic descent or anorectal angle was seen postoperatively. The electromyographical signs, e.g. duration and amplitude of action potentials, average amplitude, and integrals of the curves did not change significantly after the operation. The mean right pudendal nerve terminal motor latency (PNTML) increased from 2.38 ms before to 2.59 ms after surgery (P>0.05). No significant change in the continence and defaecation index was seen postoperatively.Zusammenfassung Diese Studie untersucht die funktionellen Langzeitergebnisse der posterioren Raffung bei der idiopathischen Inkontinenz. Einunddreigig Patienten mit J, einem Durchschnittsalter von 65,6 Jahren wurden nach 2 bis 71/2 Jahren (durchschnittliches Follow-up 4,2 Jahre) nachuntersucht. Bei 16 Patienten (52%) kam es zu einer Verbesserung der Kontinenzleistung, allerdings nur 2 Patienten (6 %) erlangten die komplette Kontinenz. Es wurde postoperativ keine signifikante Verfinderung in bezug auf den Ruhe-und Kontraktionsdruck, die Beckenbodenebene und den anorektalen Winkel beobachtet. Die elektromyographischen Zeichen wie Aktiouspotentialdauer, H6he der