Neuropathic bladder dysfunction in patients with motor complete and sensory incomplete spinal cord lesion

Rapidi, Christina-Anastasia; Petropoulou, Konstantina; Galata, Angeliki; Fragkaki, M.; Kandylakis, Emmanuel; Venieri, Mara; Tzavara, Ch.

doi:10.1038/sc.2008.16

Cited by 12 publications

(11 citation statements)

References 23 publications

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“…This variation was influenced primarily by the neurological level and severity of the SCI. One study 27 reported the incidences for individuals with American Spinal Injury Association Impairment Scale (AIS) A and B to be 15.9% and 21.4%, respectively. However, this study involved individuals with SCI from C4 to T12.…”

Section: Incidence Of Ad During Iatrogenic Urological Proceduresmentioning

confidence: 99%

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

et al. 2015

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Study design: This is a systematic review. Objective: The objective of this study was to review the literature on iatrogenic urological triggers of autonomic dysreflexia (AD). Setting: This study was conducted in an international setting. Methods: A systematic review was conducted from PubMed search using AD/ autonomic hyperreflexia and spinal cord injury (SCI). Studies selected for review involved iatrogenic urological triggers of AD in individuals with SCI, including original articles, previous practice guidelines, case reports and literature reviews. Studies that did not report AD or blood pressure (BP) assessments during urological procedures were excluded. Results: Forty studies were included for analysis and categorized into four groups: (1) urodynamics and cystometry; (2) cystoscopy and transurethral litholapaxy; (3) extracorporeal shock-wave lithotripsy (ESWL); and (4) other procedures. During urodynamics, the incidence of AD ranged from 36.7% to 77.8%. The symptomatic rate ranged from 50% to 65%, with AD symptoms seen predominantly in cervical SCI patients. The studies imply no consensus regarding the relationship between AD, neurogenic detrusor overactivity and detrusor sphincter dyssynergia. Without anesthesia, the majority of individuals develop AD during cystoscopy, transurethral litholapaxy and ESWL. The effectiveness of different anesthesia methods relies on blocking the nociceptive signals from the lower urinary tract (LUT) below the level of the neurological lesion. Other iatrogenic urological triggers were commonly associated with bladder filling. Conclusion: The LUT triggers of episodes of AD are often associated with iatrogenic urological procedures. AD was more prevalent in cervical SCI than in thoracic SCI. To detect this potential life-threatening complication following cervical and high thoracic SCI, routine BP monitoring during urological procedures is highly recommended.

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Section: Incidence Of Ad During Iatrogenic Urological Proceduresmentioning

confidence: 99%

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

et al. 2015

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“…Aynı çalışmada, düşük mesane kompliyansı olan grupta MCC'nin daha düşük olduğu da bildirilmiştir. Literatürde, OY'li hastalarda mesane boşaltım yöntemini etkileyen faktörleri değerlendiren çok az çalışma mevcuttur (8,26,27). Rapidi Kay nak lar…”

Section: Discussionunclassified

“…Ancak, bazı yazarlar nörolojik ve ürodinamik bulguların her zaman tam korelasyon göstermeyebileceğini bildirmişlerdir (4-7). Çalışmalarda, OY seviyesi ve ciddiyeti ile mesane davranışı arasındaki ilişki üzerinde durulmakta fakat mevcut çalışmaları, farklı değerlendirmelerin kullanılması nedeniyle karşılaştırmak zor olmaktadır (2)(3)(4)(6)(7)(8)(9).…”

Section: öZetunclassified

Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

Yıldız¹,

Alkan²,

Akkaya³

et al. 2011

Tftr

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Objective: It was aimed to investigate the relationship of lesion level and severity with bladder behavior based on urodynamic findings in patients with spinal cord injury (SCI). Materials and Methods: Forty nine patients who were on inpatient rehabilitation programme in our clinic with the diagnosis of SCI after the spinal shock period were included in the study. Neurological level (cervical, thoracal, lumbosacral) and severity of the lesion (complete, incomplete) were set according to the American Spinal Injury Association (ASIA) classification. It was assessed if the level and severity of the SCI related to neurogenic bladder type, maximum cystometric capacity (MCC) and compliance which were designated with urodynamic study and methods of bladder management. Results: There was no difference in terms of age, sex, disease duration, neurogenic bladder type, MCC, compliance, method of bladder management on admission according to the level and severity of the lesion among patients with SCI (p>0.05).Level and severity of SCI were significantly associated with the method of bladder drainage at discharge (r: 0.33, p<0.01 and r: 0.40, p<0.005, respectively). 90.5% of patients with complete SCI and 64.3% of patients with incomplete SCI were using clean intermittent catheterization (CIC), 32.1% of the patients with incomplete SCI urinated spontaneously, whereas none of the patients with complete SCI could urinate. It was found that 83.3% of cervical, 81.8% of thoracic and 60% of lumbosacral injured patients were using CIC. The greatest rate of spontaneous urination (40%) was observed in people with lumbosacral injuries compared to cervical and thoracic levels (8.3 and 9.1%, respectively).The significance of this difference could not be tested statistically due to the small sample size. Level (r: 0.33) and severity (r: 0.40) of SCI, MCC (r: 0.33) and compliance (r: 0.34) were all significantly correlated with the method of bladder management at discharge. Conclusion: MCC, compliance, and level and severity of injury were found to be related with the method of bladder management at discharge in patients with SCI. On the other hand, when the lesion level and severity are insufficient in determining the bladder behavior, the necessity of urodynamical evaluation arises. Turk J Phys Med Re hab 2011;57:206-11. Key Words: Spinal cord injury, neurogenic bladder, bladder behavior Özet Amaç: Omurilik yaralanmalı (OY) hastalarda lezyon seviyesi ve ciddiyeti ile ürodinamik bulgulara dayalı mesane davranışı arasındaki ilişkiyi araştırmak amaçlandı. Gereç ve Yöntem: OY tanısı ile kliniğimizde yatarak rehabilitasyon programı uygulanan, spinal şok döneminden çıkmış, 49 hasta çalışmaya dahil edildi. American Spinal Injury Association (ASIA) sınıflamasına göre, nörolojik lezyon seviyesi (servikal, torakal, lumbosakral) ve ciddiyeti (komplet, inkomplet) belirlendi. OY seviyesi ve ciddiyeti ile ürodinamik çalışma ile belirlenen nörojenik mesane tipi, maksimum sistometrik kapasite (MCC), kompliyans ve mesane boşaltım yöntemleri arasındaki ...

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“…Studies investigating lesion severity and bladder function found no significant difference between complete and incomplete lesions in terms of maximum detrusor pressure and MC (21); mean MC and mean intravesical leak-point pressures were not significantly different between AIS-A and AIS B-E patients (22); although DO was more benign in AIS-B patients than in AIS-A patients, neuropathic bladder type and compliance were not significantly different between AIS-A and AIS-B patients (23). Scivoletto et al (24) have shown that none of the patients with AIS-A impairment on admission reached volitional voiding at 5 months; AIS-B patients had a 90% lower probability of achieving good bladder control and AIS-C patients had 65% lower than AIS-D patients.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Bladder Function with Toe Position Sense, Neurological Level, Lesion Severity, and Bulbocavernosus Reflex in Patients with Spinal Cord Injury

Kulaklı¹,

Ersöz²,

Eguz³

et al. 2015

Turk J Phys Med Rehab

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Objective: Examination of the relationship among toe position sense (TPS), neurological level (cervical, thoracic, lumbosacral), severity of the lesion (complete, incomplete), bulbocavernosus reflex (BCR), and bladder behavior in patients with spinal cord injury (SCI). Material and Methods: Fifty-nine patients with SCI were included in the study. Patient characteristics, TPS, and BCR were recorded. Neurological level and lesion severity were determined according to the American Spinal Injury Association Impairment Scale (AIS) classification. Maximum cystometric capacity (MC), storage and emptying function, type of detrusor (overactive, acontractile-underactive), spontaneous voided urine volume (SVU), and post-void residual urine volume (PVR) values were established performing the urodynamic study. Results: Neurological level, lesion severity, TPS, and BCR were not significantly correlated with storage dysfunction, emptying dysfunction, type of detrusor, MC, and PVR (p>0.05). SVU was significantly lower in patients without TPS than in patients with TPS and in complete lesions than in incomplete lesions (p<0.05). Conclusion:The presence of TPS could be a predictive finding in terms of SVU. We can say that neurological level, lesion severity, and BCR are not adequate parameters to predict bladder dysfunction; therefore, urodynamic evaluation is necessary for each patient with SCI.

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Neuropathic bladder dysfunction in patients with motor complete and sensory incomplete spinal cord lesion

Abstract: Patients with somatosensory incomplete lesion of spinal cord seem to have an advantage in the management of neuropathic bladder dysfunction (fewer anticholinergics needed, fewer incontinence episodes and fewer bladder stones).

Cited by 12 publications

References 23 publications

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

Iatrogenic urological triggers of autonomic dysreflexia: a systematic review

Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

Relationship of Bladder Function with Toe Position Sense, Neurological Level, Lesion Severity, and Bulbocavernosus Reflex in Patients with Spinal Cord Injury

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