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.