The acute effect of dorsal genital nerve stimulation on rectal wall properties in patients with idiopathic faecal incontinence

• Published in: Colorectal disease 2011-09, Vol.13 (9), p.e284-e292
• Main Authors: Worsøe, J., Fynne, L., Laurberg, S., Krogh, K., Rijkhoff, N. J. M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Dilatation; Electric Impedance; Electric Stimulation Therapy; faecal incontinence; Fecal Incontinence - therapy; Female; Humans; Middle Aged; Nerve stimulation; Pressure; rectal motility; Rectum - anatomy & histology; Rectum - innervation; Rectum - physiology
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2011.02681.x

Aim  Faecal continence depends on several factors, including rectal wall properties. Stimulation of the dorsal genital nerve (DGN) can suppress bladder contraction and similar effects are anticipated for the rectum. In this study, the acute effect of DGN stimulation on the rectal cross‐sectional area is investigated. Method  Ten female patients (median age 60 years) with idiopathic faecal incontinence were included in the study. Stimulation was applied via plaster electrodes with the maximum tolerable amplitude (pulse width was 200 μs at a pulse rate of 20 Hz). Three series of pressure‐controlled phasic (10, 20 and 30 cm H2O) and stepwise (5–30 cm H2O in steps of 5 cm H2O) rectal distensions were conducted (unstimulated, stimulated, unstimulated), and the rectal cross‐sectional area (CSA) was measured with impedance planimetry. Results  All patients completed the investigation. The median stimulation amplitude was 21 (8.5–27) mA. Comparing stimulated with unstimulated phasic distension, there was no significant difference in the median rectal CSA. Comparing stimulated with unstimulated stepwise distension, there was no significant difference in the median rectal CSA. Neither the rectal pressure‐CSA relationship (CSA/PR) nor the rectal wall tension changed during stimulation. Conclusion  No acute effect on rectal CSA during pressure‐controlled distension was demonstrated during DGN stimulation.