The Video-Urodynamic and Electrophysiological Characteristics in Patients With Traumatic Spinal Cord Injury

International Neurourology Journal, 2021 · DOI: https://doi.org/10.5213/inj.2040376.188 · Published: December 31, 2021

Simple Explanation

This study investigates the relationship between the level of spinal cord injury (SCI), urodynamic findings, and electrophysiological data in patients with traumatic SCI. The study found a significant correlation between the level of SCI and video-urodynamic findings, but clinical examination alone cannot accurately predict bladder function, highlighting the necessity of urodynamic testing. The study also suggests that bladder sensation is important for urinary control in patients with traumatic SCI.

Study Duration

February 2012 to July 2018

Participants

647 patients with traumatic SCI

Evidence Level

Not specified

Key Findings

1
A significant correlation was found between the level of SCI and video-urodynamic findings, but clinical examination cannot accurately predict bladder function.
2
Patients with detrusor overactivity (DO) and/or detrusor sphincter dyssynergia (DSD) had a longer duration of SCI at each injury level than patients with detrusor areflexia (DA).
3
Bladder sensation (BS) is important for urinary control in patients with traumatic SCI, as patients with BS had a higher bladder capacity during urine leakage.

Research Summary

This study aimed to determine the characteristics of detrusor behavior, urodynamic examination findings, and neurophysiological tests in patients with traumatic SCI. The results showed a correlation between the level of injury and urodynamic findings but no correlation with the degree of injury. The study concludes that urodynamic examination is necessary to determine lower urinary tract function, while pelvic floor electrophysiological examination may not be essential for SCI patients.

Practical Implications

Improved Diagnostic Accuracy

Urodynamic testing should be used in conjunction with clinical examination to accurately assess bladder function in SCI patients.

Targeted Bladder Management

Bladder management strategies should consider the duration of injury and the presence or absence of bladder sensation.

Limited Role of Electrophysiology

Pelvic floor electrophysiological examination may have limited value in guiding bladder management for SCI patients.

Study Limitations

1
The retrospective nature of the study limited the inclusion of SCI patients with normal micturition reflex.
2
The study could not evaluate differences of urodynamic results between patients with indwelling and with intermittent catheterization.
3
The study could not provide a reasonable explanation why incomplete SCI patients with normal BCR had a higher incidence of DA than those with complete injury.

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