Urinary tract reconstruction: Applied urodynamics

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Abstract
Sixty‐four patients underwent urinary reconstruction guided by urodynamic investigation. Twenty‐eight patients had myelodysplasia (MM) and 26 had spinal cord injuries (SCI). Operative outcomes were assessed by repetitive urodynamic testing.Bladder reservoir function and detrusor contractile activity were correctly assessed in all 64 patients. Operative creation of a more adequate reservoir was required in 58 patients.Assessment of urethral continence function was inaccurate in six instances wherein we judged urethral sphincter function adequate when, in fact, it was not. Ureteral function was judged radiographically or by furosimide renography, or Whitaker perfusion testing. In the two instances where ureteral function was in doubt, it made no difference in outcome. There was a striking resolution of ureteral radiographic abnormalities after reconstruction which we attribute to the low‐pressure reservoir.