Detrusor reflex contraction inhibited by anal stretch

Anal stretch has been advocated as a method to overcome detrusor-sphincter dyssynergia. In evaluating candidates for this technique, it has been observed that in some cases the detrusor reflex and the external sphincter contraction is inhibited. The detrusor-sphincter unit then assumes a lower motor neuron pattern. This explains the need of the Valsalva and Credé maneuver that had been incorporated in the anal stretch technique to allow dyssynergic patients to void.