Urodynamic findings, bladder emptying methods and therapeutic approaches in patients with upper lumbar and lower lumbar–sacral spinal cord injury

Abstract

There have been previous reports of both demographic and clinical features with urodynamic evaluation results of patients with traumatic spinal cord injury (SCI). These studies were conducted on patients with cervical and thoracal SCI, but there has been no comparative study evaluating the urodynamic outcomes of patients with lumbosacral SCI. Therefore, it was aimed to investigate the bladder features and treatment options in patients with lumbosacral SCI to be able to take appropriate therapeutic decisions. The urodynamic data of 121 patients with lumbar and sacral SCI were obtained retrospectively using the urodynamics unit records. The patients were grouped as upper lumbar (L1 and L2) SCI (ULSCI) and lower lumbar-sacral (L3 to S5) SCI (LLSSCI). The patients were 92 males (76 %) and 29 (24 %) females, comprising 74 (61.2 %) ULSCI patients and 47 (38.8 %) LLSSCI patients. Detrusor hypocompliancy and anticholinergic prescription were more frequent in the ULSCI group than in the LLSSCI group, while alpha-blocker prescription was more frequent in the LLSSCI group than in the ULSCI group. There was a statistically significant difference between the groups in respect of the rates of bladder-emptying method on admission. A higher mean micturated urine volume was observed in the LLSSCI group than in the ULSCI group. The rates of bladder-filling sensation, detrusor overactivity, bladder-storage and emptying disorders, prescribed emptying method, and residual urine volume were similar in both groups. These results showed that there are differences in neurogenic bladder features and treatment options for patients with upper lumbar and lower lumbar-sacral SCI.

Association between detrusor muscle function and level of the spinal cord injury

“…Although a higher value of bladder hypocompliance and detrusor sphincter dyssynergia were observed in the suprasacral lesion group, we found higher voided urine volume and consequently lower residual urine volume in patients with the suprasacral lesion. The storage disorder had a higher rate (67.8%) in the suprasacral lesion which had been previously reported [ 9 ]; it can be consistent with more bladder hypocompliance in the suprasacral lesion. Additionally, the emptying disorder was higher (64.4%) in the suprasacral lesion as well, which may show the role of internal urethral sphincter function (innervated by the hypogastric nerve originating from T10–L2).…”

“…Management of the urinary tract has an important role in improving quality of life and reducing the mortality in patients with SCI. The most instructive and essential procedure for this management is the urodynamic evaluation [ 9 ]. The urodynamic investigation is the only method that can objectively assess the function of the lower urinary tract [ 10 ].…”

Methoxytetrahydro‐2H‐pyran‐2‐yl)methyl benzoate inhibits spinal cord injury in the rat model via PPAR‐γ/PI3K/p‐Akt activation

“…Spinal cord injury (SCI) is among the serious nervous system disorders characterized by complete or partial damage to motor function resulting in movement loss . Efforts are being continuously made to develop better treatment strategies for SCI .…”

Wogonoside alleviates inflammation induced by traumatic spinal cord injury by suppressing NF-κB and NLRP3 inflammasome activation

“…Spinal cord injury (SCI) is a common type of trauma and cause of disability in China (1). The underlying mechanisms that cause secondary neuron injury following primary spinal cord injury are complex (2).…”