Background: To clarify the puborectalis muscle (PM) function in pediatric patients with soiling after ileal J-pouch-anal anastomosis (IPAA) for ulcerative colitis, the author examined the neurological functions of the PM.

Methods: Twelve patients 3 months after IPAA were studied (average age 13.6 years). Five patients showed soiling every day (group A1) and 7 patients showed soiling 2 to 3 days per week (Group A2). All patients 1.5 years after IPAA showed continence (group B). Twenty subjects served as a control (Group C; average age 13.5 years). Right, left and posterior sides of the sacral nerve terminal motor latency (SNTML) were measured by magnetic stimulation.

Results: On the right, left and posterior sides, patients in group A1 exhibited significant prolongation of the SNTML compared with patients in groups A2, B and C (P<.05 each). Group A2 exhibited significant prolongation compared with groups B and C (P<.05 each). There were no significant differences of the SNTML between right and left sides, between right and posterior sides and between left and posterior sides in groups A1, A2, B and C.

Conclusions: The SNTML of the PM demonstrates significant latency in those children who have early post-IPAA soilage. The neurological function of the PM potentially injured during an operation may recover, and correlates with normalization of continence.