Can neurologic examination predict type of detrusor sphincter-dyssynergia in patients with spinal cord injury?

Details

Serval ID
serval:BIB_B1DF44FFB8C3
Type
Article: article from journal or magazin.
Collection
Publications
Title
Can neurologic examination predict type of detrusor sphincter-dyssynergia in patients with spinal cord injury?
Journal
Urology
Author(s)
Schurch B., Schmid D.M., Karsenty G., Reitz A.
ISSN
1527-9995 (Electronic)
ISSN-L
0090-4295
Publication state
Published
Issued date
2005
Volume
65
Number
2
Pages
243-246
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVES: To assess the correlations in males with spinal cord injury (SCI) between the neurologic status and type of detrusor-sphincter dyssynergia (DSD) observed during urodynamic examinations and to evaluate the change in the DSD pattern over time.
METHODS: A total of 105 male patients with chronic SCI were neurologically examined according to the American Spinal Cord Injury Association protocol and underwent video-urodynamic examinations. DSD observed during urodynamic studies was classified according to the Blaivas classification. To assess the stability of the DSD over time, patients who had been recently injured were clinically and urodynamically controlled after 1 year and thereafter.
RESULTS: A statistically significant positive correlation was found between the DSD type and completeness or incompleteness of the SCI lesion. Patients with an incomplete sensory and motor SCI lesion presented with DSD type 1 compared with patients with complete sensory and motor SCI lesion, who had DSD type 2 to type 3. A correlation was also found between the American Spinal Cord Injury Association scores and the DSD type. No correlation was found between the DSD type and lesion level. At medium to long-term follow-up, a significant change was found in the DSD type.
CONCLUSIONS: The neurologic status and DSD type after SCI showed significant correlations. Therefore, neurologic examination and determination of the DSD type might be helpful to complete the neurourologic diagnosis and to assist in confirming completeness of the lesion after acute injury. Because DSD seems to become aggravated with time, regular urodynamic follow-up examinations are mandatory in patients with DSD to adjust their treatment, if necessary.
Keywords
Adolescent, Adult, Aged, Ataxia/classification, Ataxia/diagnosis, Humans, Male, Muscle Contraction, Muscle Hypertonia/diagnosis, Muscle Hypertonia/physiopathology, Muscle, Smooth/physiopathology, Neurologic Examination, Paraplegia/etiology, Predictive Value of Tests, Quadriplegia/etiology, Spinal Cord Injuries/complications, Spinal Cord Injuries/physiopathology, Urinary Bladder/physiopathology, Urinary Bladder, Neurogenic/classification, Urinary Bladder, Neurogenic/diagnosis, Urodynamics
Pubmed
Web of science
Create date
05/11/2014 12:12
Last modification date
20/08/2019 15:20
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