Bruce H. Knox
Independent Scholar, Auckland, New Zealand
Publications
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Research Article
Rectal Distension, Pelvic Floor Reflexes, and Difficulty During Intermittent Self-Catheterisation: A Patient-Investigator Hypothesis in the Context of Secondary Autonomic Dysfunction
Author(s): Bruce H. Knox*
Background Difficulty passing an intermittent urinary catheter through the external urethral sphincter and bladder outlet is a common challenge among men who require self-catheterisation. Mechanical causes, including prostatic enlargement, urethral stricture, and bladder neck obstruction, are well recognised. The dynamic interactions among rectal filling, pelvic floor reflexes, autonomic regulation, and urinary outlet function are less well understood. Objective To examine a reproducible clinical observation in which successful intermittent catheter passage appears to depend on prior rectal evacuation, and to explore the anatomical and physiological mechanisms that may underlie this phenomenon. Methods A patient-investigator with established secondary autonomic dysfunction observed a consistent relationship between.. Read More»