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Detrusor reflex contraction inhibited by anal stretch
Archives of Physical Medicine and Rehabilitation
|March 1, 1981
Summary
Anal stretch can help with detrusor-sphincter dyssynergia by inhibiting reflexes. This leads to a lower motor neuron pattern, necessitating maneuvers like Valsalva and Credé for voiding in affected patients.
Area of Science:
- Urology
- Neuro-urology
Background:
- Detrusor-sphincter dyssynergia (DSD) is a condition affecting bladder emptying.
- Anal stretch is a proposed method to manage DSD.
Observation:
- During evaluation for anal stretch, inhibition of the detrusor reflex and external sphincter contraction was noted in some patients.
- This inhibition alters the detrusor-sphincter unit's function.
Findings:
- The detrusor-sphincter unit adopts a lower motor neuron pattern following anal stretch in specific cases.
- This neurological pattern explains the observed inhibition.
Implications:
- The lower motor neuron pattern necessitates specific voiding techniques.
- Valsalva and Credé maneuvers are integrated into the anal stretch technique to facilitate voiding for patients with DSD.