The puborectal continence reflex: a new regulatory mechanism controlling fecal continence.
The puborectal continence reflex: a new regulatory mechanism controlling fecal continence.
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DOI：
10.1007/s00384-018-3023-9
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发表时间：
2018-05
影响因子：
2.8
通讯作者：
Trzpis M
中科院分区：
文献类型：
--
作者：
Broens PMA;Jonker JE;Trzpis M
大便失禁是通过肛门括约肌的随意和不随意收缩以及耻骨直肠肌的随意收缩来维持的。我们研究了耻骨直肠肌是否可以控制大便失禁，不仅通过随意收缩，而且通过不随意收缩。我们对23名健康受试者进行了肛门直肠功能测试。肛肠压力试验用于调查耻骨直肠肌的随意收缩。球囊保留试验用于评估耻骨直肠肌是否可以不自主地收缩。在球囊保留试验中，我们观察到耻骨直肠肌的不自主收缩，在直肠逐渐填充过程中逐渐增加。耻骨直肠肌的最大不随意收缩明显强于其最大随意收缩（150比70 mmHg， P < 0.001, 5.8比1.5 min, P < 0.001）。我们发现耻骨直肠肌在直肠扩张时能够不自主地收缩。这是一种新的调节机制，称为耻骨直肠失禁反射，它通过耻骨直肠肌的不自觉收缩来控制大便失禁。它似乎是由耻骨直肠肌水平的扩张引起的。据推测，耻骨直肠失禁反射保护许多肛门括约肌功能障碍患者免于大便失禁。
Fecal continence is maintained by voluntary and involuntary contraction of the anal sphincter, and voluntary contractions of puborectal muscle. We investigated whether the puborectal muscle can control fecal continence not only by voluntary contractions but also by involuntary contractions. We performed anorectal function tests in 23 healthy subjects. The anorectal pressure test was used to investigate voluntary contractions of the puborectal muscle. The balloon retention test was used to assess if the puborectal muscle can contract involuntarily. During the balloon retention test, we observed an involuntary contraction of the puborectal muscle, which gradually increased during progressive filling of the rectum. The maximal involuntary contraction of the puborectal muscle was significantly stronger and longer than its maximal voluntary contraction (150 versus 70 mmHg, P < 0.001 and 5.8 versus 1.5 min, P < 0.001). We found that the puborectal muscle is able to contract involuntarily during rectal dilatation. It is a new regulatory mechanism, called the puborectal continence reflex, which controls fecal continence by involuntary contraction of the puborectal muscle. It seems to be initiated by dilatation at the level of the puborectal muscle. Presumably, the puborectal continence reflex protects many patients with anal sphincter dysfunctions from fecal incontinence.
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影响因子：
3.9
作者：
Broens, Paul M. A.;Penninckx, Freddy M.;Boix Ochoa, Jose
通讯作者：
Boix Ochoa, Jose
影响因子：
9.8
作者：
Siproudhis, L;Bellissant, E;Gosselin, M
通讯作者：
Gosselin, M
影响因子：
29.4
作者：
Bharucha, AE;Zinsmeister, AR;Melton, LJ
通讯作者：
Melton, LJ
影响因子：
29.4
作者：
Nelson, RL
通讯作者：
Nelson, RL
影响因子：
29.4
作者：
Whitehead WE;Borrud L;Goode PS;Meikle S;Mueller ER;Tuteja A;Weidner A;Weinstein M;Ye W;Pelvic Floor Disorders Network
通讯作者：
Pelvic Floor Disorders Network