Urethral Hypotonicity After Suprasacral Spinal Cord Injury

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Abstract
Established suprasacral spinal cord injuries usually are associated with detrusor hyperreflexia and varying degrees of detrusor-sphincter dyssynergia. Occasionally, such injuries result in detrusor areflexia or urethral hypotonicity or both. The results of the urodynamic evaluation of 4 patients with suprasacral spinal cord injuries are described. Detrusor areflexia and urethral hypotonicity were demonstrated in 3 cases and urethral smooth muscular hypotonia but preserved reflex detrusor function in 1. Destruction of the thoracolumbar sympathetic outflow can cause the complete loss of urethral smooth muscular closing function; resting urethral closure is totally independent of preganglionic cholinergic influences.