Bladder Recovery in Patients With Traumatic Cervical Cord Injury Evaluated by Voiding Synchronous Cystosphincterometry With Uroflowmetry

Publisher Website
Google Scholar
Abstract
Voiding synchronous cystosphincterometry with uroflowmetry was used in 16 patients with traumatic cervical cord injury to evaluate bladder recovery. This method was reliable, since the statistical analysis of the voiding responses showed the same values with repeated tests. Patients (14) with such injuries recovered from shock in 6 wk; 10 acquired mature bladder contraction with a synergic external sphincteric urethra .apprx. 13 wk after spinal cord injury. Bladders in patients with cervical cord injury usually recover from a state of inactive detrusor to that of a mature contraction by way of immature small and/or sustained contractions. Pressure measurements revealed 7.1 .+-. 3.7 cm water in the empty bladder and 74 .+-. 20.5 cm water (43 .+-. 13.3 s in duration) in the recovered bladder contraction, and it usually improves to the synergic state, according to the degree of maturity of bladder contraction. The bladder and external urethral sphincter recover independently and a synergic response develops even in cases of complete lesions. Synergy can be accomplished by regulatory mechanisms at the sacral cord level. Surgical intervention should be postponed if the maturity of bladder contraction is not established. More precise objective information on the dyssynergic bladder caused by cervical cord injury can be obtained when voiding synchronous cystosphincterometry with uroflowmetry is used.