Mutual influence between vesicourethral and anorectal function in spinal cord injury patients.

There is clinical evidence of a relationship between urethrovesical and anorectal dysfunction in spinal cord injured patients. This study was performed to assess how rectal distension could influence the results of urodynamic investigations. Ten patients with spinal cord injury were submitted to repeated urodynamic evaluations under different rectal conditions after performing complete anorectal testing. Distension of the rectal ampulla may interfere with vesicourethral function in spinal cord injured patients: in those with complete spinal cord lesions rectal distension causes a reduction in bladder compliance, earlier and higher amplitude of the first hyperreflexic contraction, and an increase in detrusor-external urethral sphincter dyssynergia. We suggest that urodynamic evaluation of spinal cord injured patients should not normally be performed if the patient has a full rectum.