Urethral Pressure Profile during the Spinal Shock Stage in Man: A Preliminary Report

Abstract

The functional state of the proximal urethra in the spinal shock stage in man is not fully understood. We studied patients with spinal cord injuries during spinal shock and found that the urethral pressure profile had a normal configuration, the peak profile pressure increased with bladder filling and phentolamine (10 mg. intravenously) reduced the peak pressure, with empty and full bladders.

Central Cord Syndrome- A Clinical Study

“…I. in his study regarding management of neurogenic bladder dysfunctions following acute traumatic cervical central cord syndrome (incomplete tetraplegia)says based on the experience to date with central cord syndrome most or all of the following conditions should be present before considering transurethral sphincterotomy. 6 Shincterotomy is indicated in patients with persistent residual urine level over 300 mls, prolonged intermittent Catherization over 6 months period, 50 years or more persons with marked spasticity of bladder etc. In our study we have put all suspected cases with catheter and removed it as early as possible to replace it with intermittent catheterization.…”

Transurethral Sphincteroresection in Traumatic Tetraplegia

“…In fact, the UPP peak pressure increases in most cases of spinal cord injury in acute stadium [6,7], After the recovery stadium, especially in the supranu clear type, the posterior urethra indicates often an open state according to the reflectory urinating reaction. The trigger point for initiation of urination is assumed at the posterior urethra, and this assumption was assured by a prevoiding drop of this posterior urethra [8],…”

“…The posterior urethra including bladder neck stays closed in the acute stadium of spinal cord injury patients; this state arises not only from its structural property of bladder neck muscles [5], but also from abnormally acti vated sympathetic reaction [6]. In fact, the UPP peak pressure increases in most cases of spinal cord injury in acute stadium [6,7], After the recovery stadium, especially in the supranu clear type, the posterior urethra indicates often an open state according to the reflectory urinating reaction.…”

Cystometry and UPP Measurement under Fluoroscopic Visualization by means of X-Ray Television in Patients with a Traumatic Spinal Cord Lesion

“…First of all, for this purpose it is important to observe the cystometric curve; it is too early to adopt the surgical pro cedure as TUR if the cystometric curve still remains in the atonic state. In this stage, in cases which have increased UPP levels and a closed bladder neck in the full bladder, ad ministration of a-adrenolytic drugs to begin urination training should be considered [4][5][6], Furthermore, in the cases of which cys tometric findings have recovered to auto nomic types, indicating the same closed blad der neck and increased urethral pressure, it is more useful to adopt the above-mentioned a-adrenolytic drugs together with parasym pathomimetic drugs, because neural innerva tion to detrusor muscle is already recovering. On the other hand, in the group having the decreased urethral pressure in the full blad der, there was no case with a closed bladder neck, therefore the administration of a-adrenolytic drugs was not necessary for such cases.…”