The clinical significance of rectal contractions that occur during urodynamic studies

Rectal contractions (RC) while performing filling cystometry are frequently detected, the clinical significance of RC has not been investigated. This study analyzed the relationship between RC and clinical data.

A retrospective analysis was performed in 5,026 patients with voiding dysfunction between June 2002 and April 2008. The RC were classified according to the maximal amplitude (higher or lower than 15 cmH(2)O) and rhythmicity; group I (rhythmic, high, 4.6%), group II (rhythmic, low, 61.2%), group III (random, high, 2.5%), and group IV (random, low, 31.7%). All the clinical and urodynamic data were made in a retrospective setting for lower urinary tract symptoms and past medical history.

RC were found in 6.5% (188 males and 139 females). Bladder compliance was decreased and bladder trabeculations were more common in patients with RC. The occurrence of RC was correlated with the development of cerebrovascular accidents in males. Among the females, the occurrence of oligopontocerebellar atrophy, spinal lesions, and the cauda equine syndrome were more common. Group I had a correlation with a spinal cord injury in males, bladder trabeculations and vesicoureteral reflux in females; group II was correlated with an idiopathic overactive bladder in both men and women, stress urinary incontinence and mixed urinary incontinence in females. No correlation was found in groups III and IV.

RC were correlated with neurological disease and non-neurological conditions. The identification of a rhythmic RC should be followed by screening for underlying conditions.