Function of hollow viscera in children with constipation and voiding difficulties

We wished to investigate the urodynamic characteristics and colonic motilit y in a group of children with severe chronic constipation and lower urinary tract symptoms, We performed colonic manometry using an endoscopically pla ced catheter. The urodynamic studies consisted of cystometry, electromyogra phy of the external urethral sphincter, measurement of urinary flow rate, a nd urethral pressure profile, We found abnormal colonic motility in all pat ients. Findings included: absent gastrocolonic response (N = 8), absent hig h-amplitude propagated contractions (HAPCs) (N = 4), and abnormal propagati on of HAPCs (N = 7), Urodynamic features were abnormal in 10 children. Find ings included: uninhibited bladder contractions (N = 6), hypertonic bladder (N = 2), sphincter dyssynergy (N = 2), small capacity bladder (N = 1). In all children constipation improved, in three after a partial colectomy. Uri nary symptoms persisted. We conclude that some children with severe constip ation may have a neuropathy affecting both the colonic and lower urinary tr acts systems. In this group of patients treatment of constipation does not result in resolution of urinary symptoms.