Abstract
Pelvic floor disorders as they relate to the colorectal surgeon focus primarily on fecal incontinence and obstructive defecation. Both disorders incorporate the use of a variety of pelvic floor diagnostic tests including anal manometry, balloon expulsion testing, electromyography (EMG), anal endosonography, defecography, and pudendal nerve terminal motor latency testing. Patients with fecal incontinence are trialed on medical therapy including bulking agents, anti-diarrheals, and biofeedback. If those measures prove ineffective, the patient should undergo anal manometry, anal endosonography, and defecography to rule out potentially surgically ameliorated fecal incontinence. If these tests prove unrevealing, a trial of sacral nerve stimulation is suggested. For complaints of constipation, the patient should undergo fiber supplementation. If this is unsuccessful and medical etiologies of constipation are ruled out, the patient should undergo anal manometry, balloon expulsion testing, EMG, and defecography to assess for dyssynergia and obstructive defecation. These diagnostic tests can elucidate potentially surgical fixes for obstructive defecation and will identify patients who will benefit from biofeedback.
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Saraidaridis, J., Bordeianou, L. (2018). Utility of Pelvic Floor Testing for Clinical Assessment of Pelvic Floor Disorders?. In: Schlachta, C., Sylla, P. (eds) Current Common Dilemmas in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-70117-2_14
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DOI: https://doi.org/10.1007/978-3-319-70117-2_14
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