Urodynamic patterns after traumatic spinal cord injury

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772313Y.0000000136 · Published: January 1, 2015

Simple Explanation

This study investigates the relationship between the level of spinal cord injury and bladder function, as determined by urodynamic studies. Urodynamic studies help in understanding how the bladder stores and releases urine. The study found that the connection between neurological findings, spinal imaging, and urodynamic findings is not always straightforward. This suggests that relying solely on clinical evaluations may not be sufficient for bladder management in SCI patients. The conclusion emphasizes the importance of incorporating urodynamic studies into bladder management plans for individuals with spinal cord injuries, to ensure appropriate care and prevent complications.

Study Duration

Not specified

Participants

70 individuals with traumatic spinal cord injury

Evidence Level

Analytical study

Key Findings

1
In patients with suprasacral injuries, a large percentage showed hyperreflexia with or without detrusor sphincter dyssynergia, indicating an overactive bladder with potential coordination issues.
2
A significant portion of patients with suprasacral injuries exhibited low bladder compliance, meaning the bladder cannot stretch easily to accommodate urine, leading to high pressures.
3
Most patients with sacral injuries showed detrusor areflexia, indicating an underactive bladder, alongside high detrusor leak point pressures, where urine leaks at a high bladder pressure.

Research Summary

This study investigated the correlation between the neurological level of spinal injury and bladder functions, as detected by urodynamic study, on seventy individuals with traumatic spinal cord injury. The study revealed that the correlation between somatic neurologic findings, spinal imaging studies, and urodynamic findings in patients with SCI is not exact. The authors concluded that bladder management should not completely rely only on clinical bladder evaluation or neurological examination alone, but should always include urodynamic studies.

Practical Implications

Improved Diagnosis

Urodynamic studies should be a routine part of the diagnostic process for SCI patients to accurately assess bladder function.

Personalized Treatment

Management plans need to be tailored based on urodynamic findings, not just neurological exam, to optimize bladder control and prevent complications.

Prevention of Complications

Regular urodynamic evaluations can help detect and manage issues like low bladder compliance and high leak point pressures early, preventing upper urinary tract damage.

Study Limitations

1
The study acknowledges that the correlation between neurologic findings and urodynamic findings is not always exact.
2
Relatively smaller sample size in sacral injury group.
3
Somatosensory testing and evoked potentials were not performed.

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