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Simultaneous dynamic electromyographic proctography and cystometrography

A C Thorpe1, N S Williams, D F Badenoch

  • 1Department of Urology, Royal London Hospital, UK.

The British Journal of Surgery
|January 1, 1993
PubMed
Summary
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This study reveals that pelvic floor dysfunction can cause both urinary and rectal symptoms. Simultaneous dynamic electromyographic proctography and cystometrography identified abnormalities in one system explaining issues in the other.

Area of Science:

  • Urogynecology
  • Pelvic Floor Disorders
  • Gastroenterology

Background:

  • The rectum and bladder share embryonic origins and physiological connections.
  • Previous investigations have not simultaneously assessed these organs dynamically.
  • Pelvic floor dysfunction is implicated in various lower urinary tract and anorectal symptoms.

Purpose of the Study:

  • To investigate the dynamic and simultaneous function of the rectum and bladder.
  • To identify correlations between rectal and urinary symptoms using a novel combined study method.
  • To explore the role of pelvic floor dysfunction in patients with combined anorectal and urinary complaints.

Main Methods:

  • Development and application of a system for simultaneous dynamic integrated electromyographic proctography and cystometrography.

Related Experiment Videos

  • Study included 41 patients (28 women, 13 men) with various pelvic floor-related symptoms.
  • Analysis focused on patients with chronic constipation and idiopathic fecal incontinence.

    • Main Results:

    • Ten of 16 women with chronic constipation exhibited obstructed micturition, often linked to puborectalis muscle dysfunction (P=0.02).
    • Rectocele and anismus were significantly associated in women with obstructed micturition (P=0.02).
    • Eight of 12 women with fecal incontinence showed genuine stress urinary incontinence, suggesting pelvic floor dysfunction as a common cause.

    Conclusions:

    • Simultaneous dynamic assessment reveals that rectal abnormalities can explain urinary symptoms, and vice versa.
    • Pelvic floor dysfunction is a significant etiological factor in patients presenting with both rectal and urinary symptoms.
    • The combined study methodology offers valuable insights into the interconnectedness of pelvic organ function.