PURPOSE: We sought to compare urodynamic parameters of ambulatory versus non-ambulatory acute spinal cord injured (SCI) patients.
PATIENTS & METHODS: A total of 60 patients (mean age 58 years, 27 women and 33 men) suffering from neurogenic lower urinary tract dysfunction (NLUTD) due to acute SCI (duration of injury < 40 days) were prospectively evaluated. The patients were dichotomized according to the Mobility for Moderate Distances subscale of the Spinal Cord Independence Measure (SCIM) version III into ambulatory (≥3) and non-ambulatory (< 3). Video-urodynamic parameters including maximum detrusor pressure during storage phase, bladder compliance, detrusor overactivity (DO), detrusor external sphincter dyssynergia (DESD), and vesico-uretero-renal reflux were compared between the two groups.
RESULTS: Of the 60 acute SCI patients, 17 were ambulatory and 43 non-ambulatory patients, respectively. Mean duration of injury at urodynamic investigation was 30 ± 8 days. The lesion level was cervical in 14, thoracic in 28, lumbar/sacral in 18 patients. Comparing unfavorable urodynamic parameters, no significant differences were found between ambulatory versus non-ambulatory patients: high-pressure system during storage phase (29% versus 33%, p=0.81), low-compliance bladder (12% versus 7%, p=0.54), DO (24% versus 47%, p=0.1), DESD (18% versus 21%, p=0.77), and vesico-uretero-renal reflux (0% versus 5%, p=0.36).
CONCLUSIONS: In acute SCI, ambulatory and non-ambulatory patients have a similar risk for unfavorable urodynamic measures. Thus, we strongly recommend the same neuro-urological assessment including urodynamic investigations in all acute SCI patients independent of the walking ability.
Written by:
Bellucci CH, Wöllner J, Gregorini F, Birnböck D, Kozomara M, Mehnert U, Schubert M, Kessler TM. Are you the author?
Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
Reference: J Urol. 2012 Oct 12. pii: S0022-5347(12)05194-4.
doi: 10.1016/j.juro.2012.10.013
PubMed Abstract
PMID: 23069382
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