Scaglia M, Delaini G G, Ribero F, Comotti F, Campra D, Hultén L
Divisione di Chirurgia Generale, Ospedale Maria Vittoria, Torino.
Chir Ital. 1993 Feb-Dec;45(1-6):124-31.
It has been suggested that incontinent patients with rectal prolapse develop a relaxation of the internal sphincter at a lower filling volume than those with the same disorder who were continent. A constant relaxation of the internal sphincter during filling before the individual experiences a need to defecate could be a contributory cause of the incontinence in these patients. Aiming to evaluate the former observations we have investigated continent and incontinent patients, with complete and internal rectal prolapse, by mean of the recto-anal manovolumetry. 31 patients were studied, 21 had a complete rectal prolapse and 10 had internal rectal prolapse and 28 sex and age matched controls were selected among volunteers. No difference has been found between the continent and incontinent patients with rectal prolapse, in term of sensory function studied by graded isobaric distention. Moreover, no difference has been found between the rectal volume at which perception of filling and relaxation of the internal sphincter during filling occurs. Therefore, in this respect, the present data are not in agreement with the theory proposed.
有人提出，直肠脱垂的失禁患者与患有相同疾病但能控制排便的患者相比，在较低的充盈量时就会出现内括约肌松弛。在个体感到有排便需求之前，充盈期间内括约肌持续松弛可能是这些患者失禁的一个促成原因。为了评估之前的观察结果，我们通过直肠肛管压力容积测定法对患有完全性和内直肠脱垂的能控便和失禁患者进行了研究。共研究了31例患者，其中21例患有完全性直肠脱垂，10例患有内直肠脱垂，并在志愿者中选择了28名性别和年龄匹配的对照者。在通过等压分级扩张研究的感觉功能方面，直肠脱垂的能控便患者和失禁患者之间未发现差异。此外，在出现充盈感知和充盈期间内括约肌松弛时的直肠容积方面也未发现差异。因此，在这方面，目前的数据与所提出的理论不一致。
