Urodynamic responses to anal stretch in patients with detrusor sphincter dyssynergia

Abstract

Objective: To evaluate the urodynamic responses to anal stretch in patients with detrusor sphincter dyssynergia (DSD).

Design: Descriptive study.

Setting: Rehabilitation hospital affiliated with a medical university.

Participants: Patients (N=36) with suprasacral spinal cord injury who had DSD confirmed on cystometrography.

Interventions: Not applicable.

Main outcome measures: Detrusor pressure, urethral pressure, and summated electromyogram of external urethral sphincter on cystometrography.

Results: The urodynamic responses to anal stretch were evaluated in the first half (time 1, 1-15s) and the second half (time 2, 16-30s) of the evaluation time period. The activity of external urethral sphincter was reduced significantly in both times 1 and 2 (P<0.5). The medians of reduction percentages were 33% and 35% for times 1 and 2, respectively. The change of detrusor pressure was not significant in either time 1 or time 2.

Conclusions: Anal stretch can reduce the activity of external urethral sphincter without significant change in detrusor pressure.