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Title: Studies in anorectal disorders : faecal incontinence and intractable constipation
Author: Papachrysostomou, Maria
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1992
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The thesis discusses disorders of anorectal and pelvic floor function, i.e. faecal incontinence and intractable constipation. Relevant anatomy, physiology and methodology are first described. Newer forms of apparatus were applied such as a surface anal plug electrode for non-invasive integrated electromyography, a pudendo-anal reflex electrical stimulator for activating the external anal sphincter and a form of EMG biofeedback for relaxation of the pelvic floor musculature. An essential part of the study is anorectal manometry. Various systems for the measurement of pressure are contrasted using both analogue and digital recorders. The digital system was the more sensitive, but the analogue system using a microballoon was free of orientational changes. Over 200 patients with idiopathic faecal incontinence were examined by manometric and somatosensory testing, the majority of whom had pudendal neuropathy. Four subgroups were characterised, two with impairment of either the external or internal anal sphincters, another with both sphincters affected and a fourth with no apparent sphincter deficit but presenting an abnormal rectal compliance. The effect of stimulating the sacral outflow from the spinal cord, via the pudendal nerve to the sphincter mechanism, was therefore assessed and revealed significant improvement in tests of anorectal function.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available