24-hour rectal manometry for overactive bladder.
OBJECTIVE
We describe prolonged rectal manometry used to characterize rectal motor activity patterns and possible rectum-bladder interaction during defecation and micturition in children with nonneuropathic overactive bladder.


METHODS
We evaluated 10 children with a mean +/- SD age of 9.7 +/- 1.3 years with overactive bladder who underwent urodynamics and 24-hour rectal manometric recording. All records were analyzed visually. Rectal contractions were defined as pressure runs exceeding 5 cm H(2)O and lasting longer than 5 seconds.


RESULTS
Three rectal motility patterns were noted in all children, including 1) slow tonic pressure waves with a frequency of 3 to 12 per hour, b) rectal motor complexes with a frequency of 3 to 10 per minute and c) single contractions 10 to 30 seconds in duration. The median nocturnal duration of rectal motor complexes was longer than that during the day (16.3 minutes, range 10.8 to 18.8 vs 11.0, range 8.9 to 12.6, p <0.05). As a percent of time, median total contraction time was greater at night than during the day (51.9%, range 42.6% to 56.9% vs 30.6%, range 19.4% to 49.3%, p <0.05). Characteristic rectal activity was seen during defecation and voiding but no bladder-rectum interaction was detected.


CONCLUSIONS
We identified 3 rectal motility patterns in all children with overactive bladder. Like the upper gastrointestinal tract, the rectum shows some periodic motor activity, which is more frequent at night. No association was observed between bladder and rectal activity during micturition and defecation.
Joensson
Iben Moeller
IM
Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark. iben.jonsson@ki.au.dk
Hagstroem
Soren
S
Krogh
Klaus
K
Siggaard
Charlotte
C
Djurhuus
Jens Christian
JC
D002648:Child; D002940:Circadian Rhythm; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D012007:Rectum / Q000503:physiopathology*; D013997:Time Factors; D053201:Urinary Bladder, Overactive / Q000503:physiopathology*; D014554:Urination