B a c k g r o u n d: Assessment of the neurocontrol of the external anal
sphincter has long been restricted to investigating patients by invasive
tools. Less invasive techniques have been regarded less uitable for
O b j e c t iv e: The aim was to develop a surface
electromyography-based algorithm to facilitate fecal incontinence
diagnosis, and to assess its sensitivity and specificity.
D e s i g n: Data analysis from a single center prospective study.
P a t i e n t s: All patients from colorectal surgery office were
considered. They underwent a structured interview, a general physical
and proctologic examination. Patients with diagnosed fecal incontinence
(Fecal Incontinence Severity Index >10) were included into the study
group. The control group consisted of healthy volunteers that scored 5
or less and had negative history and physical exam. Both groups
underwent the same tests (rectoscopy, anorectal manometry, transanal
ultrasonography, multichannel surface electromyography and assessment of
M e t h o d s: EMG results were analyzed to find parameters that would
facilitate fecal incontinence diagnosis.
O u t c o m e m e a s u r e s: Sensitivity and specificity of surface
electromyography, to diagnose fecal incontinence, were assessed.
R e s u l t s: A total of 49 patients were included in the study group
(mean age ± SD 58.9 ± 13.8). The control group (n = 49) gender matched
the study group (mean age ± SD 45.4 ± 15.1). The constructed
classification tree, based on surface electromyography results,
correctly classified 97% of cases. The sensitivity and specificity of
this classification tree, to diagnose FI, was 96% and 98% respectively.
L i m i t a t i o n s: The age of women in the control group differs
significantly from mean age of other groups.
C o n c l u s i o n s: Surface electromyography is an good tool to
facilitate diagnosing of fecal incontinence.