COLONIC TRANSIT-TIME IN PATIENTS WITH MYELOMENINGOCELE

To evaluate colonic motility in patients with myelomeningocele, the tr ansit time of radiopaque markers was studied in 22 patients with myelo meningocele and 22 age and sex matched controls. Mean colonic transit time was significantly longer in patients than in controls (103.2+/-49 h versus 23.3+/-13 h; P < 10(-7)). Thirteen of 22 patients with myelo meningocele were severely constipated. Six patients had constipation s econdary to delayed colonic transit, particularly in the left colon, a nd seven had increased rectosigmoid transit. The clinical questionnair e and particularly the frequency of bowel movements did not predict co lonic transit. Among 13 patients with increased colonic transit, eight had more than five bowel movements per week and, thus, six of them di d not use laxatives or enemas, despite the presence of faecal incontin ence. There was no relationship between colonic transit time and the l evel of the spinal lesion or patient mobility in patients with myelome ningocele. Rectoanal dyssynergia was found in 14 of the 22 patients, b ut equally often in patients with delayed rectosigmoid transit (4/7) a s in the other patients (10/15) (P=ns). Uninhibited detrusor contracti ons were observed more often in patients with increased colonic transi t time than in others (8/22 versus 1/8, P=0.05). in the absence of a c orrelation between colonic transit time, clinical symptoms, anorectal motility, level of spinal lesion, patient mobility, evaluation of colo nic transit of radiopaque markers should be assessed routinely in all patients with myelomeningocele to plan the most appropriate treatment, mainly in case of unhibited detrusor contractions.