Department of Surgery, Anorectal Physiology Laboratory, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Dig Dis Sci. 2019 May;64(5):1312-1319. doi: 10.1007/s10620-018-5201-6. Epub 2018 Jul 12.
Increased rectal volume is believed to be associated with diminished rectal sensation, i.e., rectal hyposensitivity.
To demonstrate that patients with increased rectal volumes do not automatically have diminished rectal filling sensations.
We, retrospectively, observed 100 adult patients with defecation problems, and 44 healthy controls who had undergone anorectal function tests. Using the balloon retention test, we analyzed the distribution of rectal volumes and pressures at different rectal filling sensation levels.
We found variance in the distribution of rectal volumes at all levels, while rectal pressures showed a normal distribution. We found no correlation between rectal volumes and pressures (constant sensation, r = 0.140, P = 0.163, urge sensation, r = - 0.090, P = 0.375, and maximum tolerable volumes, r = - 0.091, P = 0.366), or when taking age and sex into account. The findings for the patient group were congruent with those for the control group.
Participants with increased rectal volumes do not experience increased rectal pressures at any sensation level. This finding, combined with the knowledge that rectal pressure triggers rectal filling sensation, indicates that rectal filling sensations in patients with increased rectal volumes are not diminished. Therefore, "rectal hyposensitivity" should be reserved for patients with increased rectal pressure thresholds, and not for "abnormally" increased rectal volume thresholds.
人们认为直肠容量增加与直肠感觉减退有关，即直肠感觉迟钝。
证明直肠容量增加的患者不会自动出现直肠充盈感觉减退。
我们回顾性观察了 100 例有排便问题的成年患者和 44 例接受肛门直肠功能测试的健康对照者。使用球囊保留试验，我们分析了不同直肠充盈感觉水平下直肠容量和压力的分布。
我们发现所有水平的直肠容量分布都存在差异，而直肠压力呈正态分布。我们没有发现直肠容量和压力之间存在相关性（恒定感觉，r=0.140，P=0.163；便意感觉，r=−0.090，P=0.375；最大耐受容量，r=−0.091，P=0.366），也与年龄和性别无关。患者组的发现与对照组的发现一致。
直肠容量增加的参与者在任何感觉水平都不会出现直肠压力增加。这一发现，加上直肠压力引发直肠充盈感的知识，表明直肠容量增加的患者的直肠充盈感没有减弱。因此，“直肠感觉迟钝”应保留给直肠压力阈值增加的患者，而不是“异常”直肠容量阈值增加的患者。
