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Effect of perineal compression on vesical motor activity
Ahmed Shafik1, Olfat el-Sibai, Ismail Ahmed
1Department of Surgery and Experimental Research, Faulty of Medicine, Cairo University, Egypt. ashafik@ahmedshafik.org
Scandinavian Journal of Urology and Nephrology
|August 29, 2003
Summary
Digital pressure on the perineum triggers a reflex that reduces bladder contraction, known as the perineovesical reflex. This reflex pathway involves the perineal skin and urinary bladder.
Area of Science:
- Urology
- Neuroscience
- Physiology
Background:
- Digital pressure on the perineum is known to inhibit bladder contraction.
- The underlying physiological mechanism for this inhibition is not fully understood.
Purpose of the Study:
- To investigate the hypothesis that perineal pressure-induced bladder inhibition is reflex in nature.
- To identify the potential reflex pathway involved.
Main Methods:
- 21 healthy volunteers underwent assessment of vesical tone using a barostat system.
- Digital pressure was applied to the perineum while vesical tone was monitored.
- The study was repeated after anesthetizing the perineum and bladder to block potential reflex arcs.
Main Results:
- Digital perineal pressure caused a significant decrease in vesical tone (mean 67.5%).
- The response showed a mean latency of 18.6 ms.
- Anesthetization of the perineum and bladder abolished the vesical tone response, which returned after anesthesia wore off.
Conclusions:
- The findings suggest a reflex relationship, termed the "perineovesical reflex", between perineal stimulation and bladder tone.
- This reflex pathway involves both perineal skin afferents and bladder efferents.
- The perineovesical reflex may serve as a diagnostic tool for vesical motor disorders.