Influence of bladder filling parameters on rectal contractions recorded on urodynamics in a cohort of patients essentially with neurological disorders

Abstract

Purpose:Rectal contractions during cystometry are recognized as not being an artefact, however their significance and the impact of bladder filling on their characteristics remains unknown. The primary aim of this study was to assess if bladder filling had any significant effect on rectal contractions parameters. Secondary objectives were to determine any significant changes in rectal contractions depending on clinical and urodynamic patient characteristics. Materials and Methods:Patients undergoing cystometries with recordings of rectal contractions were included prospectively. Amplitude and frequency of rectal contractions during the following periods of interest were measured: beginning of cystometry (T0) to first desire to void (FDV) [T0-FDV], first desire to void to end of cystometry (End) [FDV-End], first desire to void to strong desire to void (SDV), 0 to 200 mL of filling, 200 to 400 mL of filling. Primary outcome was the difference in mean amplitude of rectal contractions before and after first desire to void ([0-FDV] vs [FDV-End]). Secondary outcomes were differences in frequency and amplitude between the different periods of interest. Results:Fifty-two patients with rectal contractions were included (mean age 54.6 ± 13.9, 83% female, 81% with neurological disease). Mean amplitude of rectal contractions increased significantly after first desire to void ([T0-FDV] = 9.3 ± 7.8 cmH 20 Vs. [FDV-End] = 12.5 ± 10.1 cmH 20; p = 0.03). No differences were found in frequency or amplitude on secondary outcomes. Patients with neurological disease had significantly greater mean amplitude of rectal contractions compared to non-neurological patients (14.1 ± 9.4 cmH 20 vs. 9.5 ± 14.1 cmH 20 respectively; p = 0.01) Conclusions:Mean amplitude of rectal contractions during cystometries increased after first desire to void, suggesting an impact of bladder sensation on rectal motricity, in favor of a sensory–motor​ cross-talk.