ADRENERGIC CONTROL OF THE INTERNAL ANAL-SPHINCTER IS ABNORMAL IN PATIENTS WITH IDIOPATHIC FECAL INCONTINENCE

被引：32

作者：

SPEAKMAN, CTM

HOYLE, CHV

KAMM, MA

HENRY, MM

NICHOLLS, RJ

BURNSTOCK, G

机构：

[1] UNIV LONDON UNIV COLL,DEPT ANAT & EMBRYOL,LONDON WC1E 6BT,ENGLAND

[2] UNIV LONDON UNIV COLL,CTR NEUROSCI,LONDON WC1E 6BT,ENGLAND

来源：

BRITISH JOURNAL OF SURGERY | 1990年 / 77卷 / 12期

关键词：

INNERVATION; INTERNAL ANAL SPHINCTER; ELECTRICAL FIELD STIMULATION; NORADRENALINE;

D O I：

10.1002/bjs.1800771208

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

There is histological and functional evidence that the internal anal sphincter is abnormal in patients with idiopathic faecal incontinence. The in vitro responsiveness of the internal anal sphincter to noradrenaline (an important sympathetic neurotransmitter) and electrical field stimulation (known to stimulate the intrinsic innervation) has been studied. Muscle strips from eight patients with incontinence undergoing postanal repair and five controls undergoing resection for low rectal carcinoma were studied. The contraction-response curves for noradrenaline were significantly different, and the EC50, the concentration required to produce 50 per cent of maximum contraction, was higher in incontinent patients (P < 0.001). Electrical field stimulation produced initial contractions in four of the control group which were blocked by phentolamine. This contraction was not present in the incontinent patients (P < 0.01). These results indicate an abnormality in the adrenergic innervation of the internal anal sphincter in patients with idiopathic faecal incontinence.

引用

页码：1342 / 1344

页数：3

共 28 条

[1]

Neill ME, Swash M, Increased motor unit fibre density in the external anal sphincter muscle in anorectal incontinence: a single fibre EMG study, J Neural Neurosurg Psychiatry, 43, pp. 343-347, (1980)

[2]

Neill ME, Parks AG, Swash M, Physiological studies of the pelvic floor in idiopathic faecal incontinence and rectal prolapse, Br J Surg, 68, pp. 531-536, (1981)

[3]

Kiff ES, Swash M, Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence, Br J Surg, 71, pp. 614-616, (1984)

[4]

Bartolo DCC, Jarratt JA, Read MG, Donnelly TC, Read NW, The role of partial denervation of the puborectalis muscle in idiopathic faecal incontinence, Br J Surg, 70, pp. 664-667, (1983)

[5]

Womack NR, Morrison JFB, Williams NS, The role of pelvic floor denervation in the aetiology of idiopathic faecal incontinence, Br J Surg, 73, pp. 404-407, (1986)

[6]

Parks AG, Swash M, Urich H, Sphincter denervation in anorectal incontinence and rectal prolapse, Gut, 19, pp. 656-665, (1977)

[7]

Beersiek F, Parks AG, Swash M, Pathogenesis of anorectal incontinence

[8]

a histometric study of the anal canal musculature, J Neural Sci, 42, pp. 111-127, (1979)

[9]

Duthie HL, Watts JM, Contribution of the external anal sphincter to the pressure zone in the anal canal, Gut, 6, pp. 64-68, (1965)

[10]

Frenckner B, von Euler C, Influence of pudendal block on the function of the anal sphincters, Gut, 16, pp. 482-489, (1975)

← 1 2 3 →