Relationship between desire to void and bladder capacity and rectal sensory function in patients with multiple sclerosis and anorectal disorders

Neurourol Urodyn. 2020 Apr;39(4):1129-1136. doi: 10.1002/nau.24330. Epub 2020 Mar 12.

Abstract

Aims: The primary aim of this study was to assess the relationship between a strong desire to void (SDV) and rectal sensory function in patients with multiple sclerosis (PwMS) and anorectal disorders. The secondary aim was to identify clinical, urodynamic or manometric factors associated with greater rectal sensory function impairment in this population.

Methods: Thirty PwMS (mean age 49.2 ± 10.9 years) with anorectal disorders (constipation and/or fecal incontinence) participated in this observational study. Rectal sensory parameters during anorectal manometry were recorded at a strong desire to void and after urination (PV, post-void). The primary outcome was the desire to defecate volume. Secondary outcomes were first perception and maximum tolerated threshold volumes, presence and modulation of recto-anal inhibitory reflex.

Results: The mean desire to defecate volume was 125 ± 59 mL at SDV and 104 ± 64 mL at PV (P < .001). The mean maximum tolerated volume was 167 ± 61 mL at SDV vs 141 ± 64 mL after urination (P = .01). The other parameters were not different between SVD and PV conditions. No predictive factors for greater impairment of rectal sensory function were identified.

Conclusion: This study suggests a relationship between bladder sensation and thus bladder capacity, and rectal sensory function in PwMS and with anorectal disorders.

Trial registration: ClinicalTrials.gov NCT04057222.

Keywords: multiple sclerosis; neurogenic; rectal diseases; rectal sensation; sensation; urinary bladder.

MeSH terms

  • Adult
  • Aged
  • Anal Canal / physiopathology
  • Constipation / physiopathology
  • Defecation / physiology*
  • Fecal Incontinence / physiopathology*
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Multiple Sclerosis / physiopathology*
  • Rectum / physiopathology
  • Sensation / physiology
  • Urinary Bladder / physiopathology*
  • Urination / physiology*
  • Urodynamics / physiology

Associated data

  • ClinicalTrials.gov/NCT04057222