MUTUAL INFLUENCE BETWEEN VESICOURETHRAL AND ANORECTAL FUNCTION IN SPINAL-CORD INJURY PATIENTS

There is clinical evidence of a relationship between urethrovesical an d anorectal dysfunction in spinal cord injured patients. This study wa s performed to assess how rectal distension could influence the result s of urodynamic investigations. Ten patients with spinal cord injury w ere submitted to repeated urodynamic evaluations under different recta l conditions after performing complete anorectal testing. Distension o f the rectal ampulla may interfere with vesicourethral function in spi nal cord injured patients: in those with complete spinal cord lesions rectal distension causes a reduction in bladder compliance, earlier an d higher amplitude of the first hyperreflexic contraction, and an incr ease in detrusor-external urethral sphincter dyssynergia. We suggest t hat urodynamic evaluation of spinal cord injured patients should not n ormally be performed if the patient has a full rectum.