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Significance of rectal contractions noted on multichannel urodynamics
Author(s) -
Combs Andrew J.,
Nitti Victor W.
Publication year - 1995
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.1930140112
Subject(s) - medicine , catheter , balloon catheter , rectum , balloon , etiology , surgery , anesthesia , urology
Independent rectal contractions are frequently noted when performing multichannel urodynamics and are often considered to be artifactual. In an effort to determine if this activity is indeed significant. we reviewed 430 consecutive multichannel urodynamic studies performed on 289 patients. All studies were performed using an analog recorder at 0.5 mm/sec paper speed. Multichannel pressures included total vesical pressure measured by a urethral catheter, total abdominal pressure measured by a rectal balloon catheter, subtracted detrusor pressure (vesical minus abdominal), and uroflow measurement when possible. Rectal contractions were defined as multiple fluctuations in abdominal pressure as measured by the rectal balloon catheter which were independent of changes in total vesical pressure. These fluctuations could not be reproduced by abdominal stressing or Kegel‐type maneuvers. Contractions were noted to be of high or low amplitude, continuous or intermittent. Of the 289 patients, 109 (38%) had a study positive for rectal contractions. Similarly, 168 of 430 studies (38%) were positive. In patients with neurologic disease, rectal contractions were noted in 61/120 (51%). In patients with no history of neurologic disease, 48/169 (29%) had rectal contractions ( P < 0.001). Furthermore, when patients without a history of neurologic disease were evaluated with respect to the presence of detrusor instability, a positive study was noted in 27/67 (40%) with instability but in only 21/102 (21%) of patients without instability ( P = 0.005 ). Rectal contractions also occurred with a higher frequency in patients with bladder hyperactivity of any etiology. To further support that rectal contractions were not a randomly occurring event, a subgroup of 86 patients who had undergone multiple studies was analyzed. Studies were consistently positive or negative for rectal contractions in 86% of patients. Rectal contractions noted on multichannel urodynamics apear to be neither artifactual nor randomly occurring events. The association with neurologic disease and detrusor hyperactivity is interesting and may indicate underlying pelvic floor dysfunction. © 1995 Wiley‐Liss, Inc.