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Pelvic floor function in patients with clinically complete spinal cord injury and its relation to constipation

Danny De Looze UGent, Martine De Muynck UGent, Myriam Van Laere UGent, Martine De Vos UGent and André Elewaut (1998) DISEASES OF THE COLON & RECTUM. 41(6). p.778-786
abstract
PURPOSE: Constipation is a common problem in patients with Spinal cord injury. The aim of this study is to analyze the role of pelvic floor dysfunction in the development of constipation. METHODS: Twenty-five patients with clinically complete supraconal spinal cord injury were studied by means of colonic transit time, anal manometry, electrophysiologic testing, and sensory-evoked potentials. RESULTS: Sixteen patients had prolonged total and segmental colonic transit times (Group C), and nine patients had normal colonic transit times (Group NC). Basal pressure and anal pressure during coughing, Valsalva's maneuver, and rectal distention were diminished in all patients, but no differences were observed between Group C and Group NC. Rectal sensation was preserved in eight patients, but this was not related to the absence of constipation. In seven of these eight patients, somatosensory-evoked potentials could be recorded, which indicated an incomplete cord lesion. Synergic relaxation of the pelvic floor during straining was never observed; dyssynergia was seen in ten (7 in Group C and 3 in Group NC; P = not significant) patients. Associated peripheral nerve damage was present in 40 percent of patients but did not predispose these patients to constipation. CONCLUSIONS: Loss of rectal sensation, dyssynergic pelvic floor contraction during straining, associated peripheral nerve damage, and insufficient rise of intraabdominal pressure could not be held responsible for constipation as a result of spinal cord injury. A prolongation of the colonic transit time is the most important mechanism, and therapy should be directed toward it.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (proceedingsPaper)
publication status
published
subject
keyword
COLONIC TRANSIT-TIME, pelvic floor function, SOMATOSENSORY EVOKED-POTENTIALS, ANORECTAL FUNCTION, TRANSECTION, DYSFUNCTION, STIMULATION, SPHINCTERS, constipation, spinal cord injury
journal title
DISEASES OF THE COLON & RECTUM
Dis. Colon Rectum
volume
41
issue
6
pages
778 - 786
conference name
Annual meeting of the American Gastroenterology Association
conference location
San Francisco, CA, USA
conference start
1996-05-19
conference end
1996-05-22
Web of Science type
Article
Web of Science id
000074276100018
ISSN
0012-3706
DOI
10.1007/BF02236269
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
178611
handle
http://hdl.handle.net/1854/LU-178611
date created
2004-01-14 13:41:00
date last changed
2014-02-11 11:00:10
@article{178611,
  abstract     = {PURPOSE: Constipation is a common problem in patients with Spinal cord injury. The aim of this study is to analyze the role of pelvic floor dysfunction in the development of constipation.
METHODS: Twenty-five patients with clinically complete supraconal spinal cord injury were studied by means of colonic transit time, anal manometry, electrophysiologic testing, and sensory-evoked potentials.
RESULTS: Sixteen patients had prolonged total and segmental colonic transit times (Group C), and nine patients had normal colonic transit times (Group NC). Basal pressure and anal pressure during coughing, Valsalva's maneuver, and rectal distention were diminished in all patients, but no differences were observed between Group C and Group NC. Rectal sensation was preserved in eight patients, but this was not related to the absence of constipation. In seven of these eight patients, somatosensory-evoked potentials could be recorded, which indicated an incomplete cord lesion. Synergic relaxation of the pelvic floor during straining was never observed; dyssynergia was seen in ten (7 in Group C and 3 in Group NC; P = not significant) patients. Associated peripheral nerve damage was present in 40 percent of patients but did not predispose these patients to constipation.
CONCLUSIONS: Loss of rectal sensation, dyssynergic pelvic floor contraction during straining, associated peripheral nerve damage, and insufficient rise of intraabdominal pressure could not be held responsible for constipation as a result of spinal cord injury. A prolongation of the colonic transit time is the most important mechanism, and therapy should be directed toward it.},
  author       = {De Looze, Danny and De Muynck, Martine and Van Laere, Myriam and De Vos, Martine and Elewaut, Andr{\'e}},
  issn         = {0012-3706},
  journal      = {DISEASES OF THE COLON \& RECTUM},
  keyword      = {COLONIC TRANSIT-TIME,pelvic floor function,SOMATOSENSORY EVOKED-POTENTIALS,ANORECTAL FUNCTION,TRANSECTION,DYSFUNCTION,STIMULATION,SPHINCTERS,constipation,spinal cord injury},
  language     = {eng},
  location     = {San Francisco, CA, USA},
  number       = {6},
  pages        = {778--786},
  title        = {Pelvic floor function in patients with clinically complete spinal cord injury and its relation to constipation},
  url          = {http://dx.doi.org/10.1007/BF02236269},
  volume       = {41},
  year         = {1998},
}

Chicago
De Looze, Danny, Martine De Muynck, Myriam Van Laere, Martine De Vos, and André Elewaut. 1998. “Pelvic Floor Function in Patients with Clinically Complete Spinal Cord Injury and Its Relation to Constipation.” Diseases of the Colon & Rectum 41 (6): 778–786.
APA
De Looze, D., De Muynck, M., Van Laere, M., De Vos, M., & Elewaut, A. (1998). Pelvic floor function in patients with clinically complete spinal cord injury and its relation to constipation. DISEASES OF THE COLON & RECTUM, 41(6), 778–786. Presented at the Annual meeting of the American Gastroenterology Association.
Vancouver
1.
De Looze D, De Muynck M, Van Laere M, De Vos M, Elewaut A. Pelvic floor function in patients with clinically complete spinal cord injury and its relation to constipation. DISEASES OF THE COLON & RECTUM. 1998;41(6):778–86.
MLA
De Looze, Danny, Martine De Muynck, Myriam Van Laere, et al. “Pelvic Floor Function in Patients with Clinically Complete Spinal Cord Injury and Its Relation to Constipation.” DISEASES OF THE COLON & RECTUM 41.6 (1998): 778–786. Print.