ABSTRACT
Rectal reservoir function can be addressed therapeutically with surgical resection, but most surgical procedures for fecal incontinence aim to improve, augment, or substitute sphincteric function.
diagnostic techniques and treatment considerations The causes of fecal incontinence are multiple. To establish a meaningful therapeutic concept, it is important to identify morphologic and functional deficits of the various anatomic components contributing to anal continence. Endoanal ultrasound and MRI enable us to detect morphologic defects of the rectum and sphincteric complex. With anorectal manometry we can test and quantify the muscular function of the smoothmuscle internal anal sphincter and the striated-muscle external anal sphincter, the perception of rectal filling and distension, the compliance of the rectal reservoir, and the reflexive interaction of the rectum and anal sphincter. Electromyographic recording of the striated muscles of the external anal sphincter and the pelvic floor allows us to differentiate muscular from neurogenic defects and to estimate the extent of reinnervation. Peripheral latency recording (pudendal nerve terminal motor latency) helps to identify the location of neural damage.
