Urodynamic Responses to Anal Stretch in Patients With Detrusor Sphincter Dyssynergia

Abstract

Huang Y-H, Chen S-L, Tsai S-J, Bih L-I, Lew HL. Urodynamic responses to anal stretch in patients with detrusor sphincter dyssyngergia. 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.