Correlation of Video-urodynamic Findings and Electrophysiological Characteristics with Level and Degree of Spinal Cord Injury

Liao L1, Wang Z1

Research Type

Clinical

Abstract Category

Neurourology

Abstract 37
Neurogenic Bladder
Scientific Podium Short Oral Session 4
Wednesday 29th August 2018
11:15 - 11:22
Hall A
Spinal Cord Injury Urodynamics Techniques Retrospective Study Pathophysiology
1. Dept. of Urology, China Rehabilitation Research Center, Capital Medical University, Beijing, China
Presenter
L

Limin Liao

Links

Abstract

Hypothesis / aims of study
To investigate the relationships between the video-urodynamic findings, pelvic floor electrophysiological characteristics and the level and degree of spinal cord injury (SCI).
Study design, materials and methods
This retrospective review analyzed the clinical records, video-urodynamic and pelvic floor electrophysiological data of 647 patients with traumatic spinal cord and out of spinal shock. Patients were classified based on American Spinal Injury Association (ASIA) Impairment Scale (AIS) and video-urodynamic findings. The thoracic injury was divided to the level of T1-9 and T10-12 because the sympathetic innervation of the low urinary tract originates the T0-L2.
Results
Of the 647 patients, the proportion of cervical, T1-9 thoracic, T10-12 thoracic and lumbar spinal cord injury and conical caudal injury were 29.3% (190), 21% (136), 28.1% (182), 6.2% (40) and 15.4% (99). Detrusor overactivity (DO) with or without detrusor sphincter dyssynergia (DSD) was found in 79.5% (151/190), 61% (83/136), 35.2% (64/182), 35% (14/40) and 19.2% (19/99) of patients with cervical, thoracic (T1-9), thoracic (T10-12), lumbar and conical caudal injury respectively. Only one patient with incomplete lumbar injury had normal bladder. The other patients manifested detrusor underactivity (DU). Bulbocavernosus reflex (BCR) was found in 95.3% (191/190), 68.4% (93/136), 52.2% (95/182), 60% (24/40) and 45.5% (45/99) of patients with cervical, thoracic (T1-9), thoracic (T10-12), lumbar and conical caudal injury. However, The manifestation of BCR also related to the degree of SCI. Sensory evoked potential (SEP) was presented in 9 complete SCI patients and 70 incomplete SCI patients.
Interpretation of results
Both DO and DU are found not only in the patients with cervical and thoracic SCI but also in ones with lumbar and conical caudal SCI; SPE is existed in complete SCI patients.
Concluding message
This study indicated a significant correlation between the level of SCI and the video-urodynamic characteristics, but clinical examination cannot be alone to predict the type of bladder function after SCI and urodynamic testing is necessary. Additionally, the manifestation of BCR and SEP are associated with the level and degree of SCI.
Disclosures
Funding No Clinical Trial No Subjects Human Ethics Committee Ethics Committee of CRRC Helsinki Yes Informed Consent No