Dynamic Urethral Function in the Assessment of Spinal Injury Patients

Bary, P. R.; Day, Gina L.; Lewis, Patricia; Chawla, J C; Evans, C.; Stephenson, T. P.

doi:10.1111/j.1464-410x.1982.tb13508.x

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…Because there is a general agreement that electrical activ ity of the external anal sphincter is coincident with that of the external urethral sphincter in the normal subject [3], urethral pressure changes in 'static UPP' during voiding may be regarded as correlating well with electromyograp hic activity of the external urethral sphincter. And in spi nal cord injury patients, it has been reported that urethral pressure at the external sphincter zone increased coincidently with an increase of its electrical activity resulting from detrusor-sphincter dyssynergia during voiding [4][5][6]. This finding is also along the same lines as those above.…”

Section: Discussionsupporting

confidence: 79%

Assessment of Urethral Resistance at External Sphincter Zone during Voiding by Static Withdrawal Urethrometrogram

Miyagawa¹

1984

Urol Int

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We investigated the intraurethral pressure changes at the external sphincter zone during voiding act and during an attempt to contract the anal sphincter on 26 neurologically intact subjects (normal group) and 12 cases after intrapelvic surgery (6 after amputatio recti and 6 after radical hysterectomy) (disturbed group). During voiding the pressure was decreased in 25 of 26 cases of the normal group, but was increased in 11 of 12 cases of the disturbed group. In contracting the anal sphincter, urethral pressure rose in all cases of both normal and disturbed groups. A significant positive correlation (p < 0.01) was found in the urethral pressure changes between voiding and during the attempt to contract the anal sphincter in the disturbed group, but not in the normal group. It is supposed that the pressure decrease during voiding is an indication of not only normally functioning external urethral sphincter but also non-underactive detrusor, and that the pressure increase means either underactive detrusor or spastic external urethral sphincter due to detrusor-sphincter dyssynergia. To measure the urethral pressure changes at the external sphincter zone during voiding is thought to be useful for assessment of the urethral resistance at that zone.

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Section: Discussionsupporting

confidence: 79%

Assessment of Urethral Resistance at External Sphincter Zone during Voiding by Static Withdrawal Urethrometrogram

Miyagawa¹

1984

Urol Int

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“…La majorité des auteurs considèrent que la dyssynergie vésicosphinctérienne est pathognomonique des lésions médullaires [2][3][4][5]7,8,29]. Cependant, des dyssynergies vésico-striées sont décrites dans certaines pathologies encéphaliques : Parkinson, MSA, hémiplégie, démence, traumatisme crânien, toujours associées à une hyperactivité du détrusor [6,17,[30][31][32].…”

Section: Discussionunclassified

“…Classification de Bary [8]. Elle distingue 3 formes de dyssynergie à partir d'une évaluation urodynamique complète de 42 blessés médullaires complets et incomplets :…”

Section: Classificationsunclassified

Les dyssynergies urétrales

Soler¹

2007

Pelv Perineol

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Service de rééducation neurologique, centre Bouffard-Vercelli-Cerbère, cap Peyrefite, France Résumé : La dyssynergie vésicosphinctérienne (DVS) est un problème fréquent au cours des lésions médullaires pouvant déterminer des complications du haut appareil et même altérer l'espérance de vie des patients. Deux types de DVS peuvent être décrits : la DVS striée et la DVS lisse. Nous présentons une revue de ces DVS avec, notamment, les stratégies diagnostiques et les résultats des bilans urodynamiques. Mots clés : Dyssynergie vésicosphinctérienne -Vessie neurologiqueIncoordination of the urethral sphincter Abstract: Detrusor sphincter dyssynergia (DSD) is a debilitating condition in patients with spinal cord injuries. DSD carries a high risk of complications, affecting even life expectancy. Two types of DSD have been described: detrusor-external sphincter dyssynergia and detrusorinternal sphincter dyssynergia. We present a review of these forms of DSD, including diagnostic strategies and urodynamic investigations.

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“…Fifteen patients achieved complete voiding after placement of the first stent; 3 developed bladder Some degree of detrusor sphincter dyssynergia always accompanies suprasacral spinal injury and represents an active contraction of the outflow in association with an involuntary detrusor contraction ( Fig. 1) (Bary et a/., 1982).…”

mentioning

confidence: 99%

Permanent Urethral Stents for Detrusor Sphincter Dyssynergia

McInerney

Vanner

Harris

et al. 1991

British Journal of Urology

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A series of 22 patients, most of whom had spinal injuries with detrusor sphincter dyssynergia, have had Medinvent Wallstents placed across the distal mechanism. All but 8 patients had undergone outflow surgery and 11 had had repeated unsuccessful sphincterotomies. The proximal end of the stent was placed over the verumontanum unless fertility was contemplated, when it was placed immediately below the verumontanum. Fifteen patients achieved complete voiding after placement of the first stent; 3 developed bladder neck obstruction after stenting, but in 1 of these cases resolution occurred after bladder neck incision. The 3 patients with artificial urinary sphincters failed to improve after stenting. Use of the urethral stent for patients with detrusor sphincter dyssynergia and failed sphincterotomy is a major advance. It should probably be the primary treatment in selected cases. Its effect on fertility is currently under assessment.

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Dynamic Urethral Function in the Assessment of Spinal Injury Patients

Cited by 12 publications

References 7 publications

Assessment of Urethral Resistance at External Sphincter Zone during Voiding by Static Withdrawal Urethrometrogram

Assessment of Urethral Resistance at External Sphincter Zone during Voiding by Static Withdrawal Urethrometrogram

Les dyssynergies urétrales

Permanent Urethral Stents for Detrusor Sphincter Dyssynergia

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