The recto-levator reflex: the description of a new reflex and its clinical application. Preliminary report

This communication embodies the description of a technique of recording a new reflex which I call "recto-levator reflex". The study was performed on 32 normal volunteers. The technique comprises the introduction of a balloon connected with a catheter into the rectum. A concentric needle electrode was introduced into the levator ani. The rectal balloon was distended and the levator myoelectric activity was recorded. In 12 patients, the procedure was repeated after levator infiltration with xylocaine or saline. When the rectal balloon was inflated with air, the levator muscle contracted. Levator contraction increased with increasing rectal distension. Anesthetized muscle did not respond, while saline-infiltrated muscle responded to rectal distension. Latency of the reflex was calculated. The recto-levator reflex seems to play an important role at defecation. On rectal distension with stools, levator contraction opens the rectal neck. Changes in the latency or amplitude of the reflex would indicate a defect in the reflex pathway. The reflex may thus prove of diagnostic significance in defecation disorders.