Pfeifer J, Salanga V D, Agachan F, Weiss E G, Wexner S D
Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
Dis Colon Rectum. 1997 Jan;40(1):79-83. doi: 10.1007/BF02055686.
The aims of this study were first to establish whether any difference among pudendal nerve terminal motor latency (PNTML) values exists relative to diagnosis, second to determine whether left and right latencies are similar, and third to assess any correlation between age and neuropathy. Latency was elicited three times on each side, and an average latency was recorded as a result.
Between June 1989 and April 1995, 1,026 patients (775 females and 251 males) underwent PNTML study. These patients were divided into four groups according to diagnosis: Group I, fecal incontinence; Group II, chronic constipation; Group III, idiopathic rectal pain; Group IV, rectal prolapse. Overall mean age was 61.5 (range, 6-95) years. Student's t-test was used to calculate statistical differences. Patients were then analyzed according to age and gender. Correlation was calculated with the nonparametric Mann-Whitney U test.
Unilateral or bilateral prolongation of PNTML was noted in 90 patients (21.2 percent) in Group I, 80 (20.4 percent) in Group II, 22 (18.1 percent) in Group III, and 38 (42.6 percent) in Group IV. Average PNTML on the left side was 1.88 ms in Group I, 1.94 ms in Group II, 1.98 ms in Group III, and 2.12 ms in Group IV. Average PNTML on the right side was 1.85 ms in Group I, 1.94 ms in Group II, 1.99 ms in Group III, and 2.07 ms in Group IV. The only statistically significant differences in PNTML were between Groups I and IV (left, P < 0.005; right, < 0.05) and between females and males (P < 0.0001).
There is no statistically significant difference between latencies of left and right pudendal nerves. Similarly, there are no statistically significant differences among patients with fecal incontinence, chronic constipation, or chronic idiopathic rectal pain. Normal latency can be expected in patients with constipation or fecal incontinence. However, patients with rectal prolapse have a more prolonged PNTML. Age is correlated with a higher incidence of pudendal neuropathy. This study reveals significant overlap among PNTML values and diagnosis.
本研究的目的，首先是确定阴部神经终末运动潜伏期（PNTML）值在不同诊断之间是否存在差异；其次是确定左右潜伏期是否相似；第三是评估年龄与神经病变之间的相关性。每侧引出潜伏期3次，并记录平均潜伏期结果。
1989年6月至1995年4月期间，1026例患者（775例女性和251例男性）接受了PNTML研究。这些患者根据诊断分为四组：第一组，大便失禁；第二组，慢性便秘；第三组，特发性直肠疼痛；第四组，直肠脱垂。总体平均年龄为61.5岁（范围6 - 95岁）。采用学生t检验计算统计学差异。然后根据年龄和性别对患者进行分析。相关性采用非参数曼 - 惠特尼U检验计算。
第一组90例患者（21.2%）、第二组80例患者（20.4%）、第三组22例患者（18.1%）以及第四组38例患者（42.6%）出现单侧或双侧PNTML延长。第一组左侧平均PNTML为1.88毫秒，第二组为1.94毫秒，第三组为1.98毫秒，第四组为2.12毫秒。第一组右侧平均PNTML为1.85毫秒，第二组为1.94毫秒，第三组为1.99毫秒，第四组为2.07毫秒。PNTML唯一具有统计学显著差异的是第一组和第四组之间（左侧，P < 0.005；右侧，P < 0.05）以及女性和男性之间（P < 0.0001）。
左右阴部神经潜伏期之间无统计学显著差异。同样，大便失禁、慢性便秘或慢性特发性直肠疼痛患者之间也无统计学显著差异。便秘或大便失禁患者可预期潜伏期正常。然而，直肠脱垂患者的PNTML延长更明显。年龄与阴部神经病变的较高发病率相关。本研究揭示了PNTML值与诊断之间存在显著重叠。
