Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?

Abstract

Objectives:To observe neurogenic bladder pattern in patients with myelopathy by performing urodynamic study (UDS) and to observe whether it has any correlation with functional and neurological recovery.Patients and Methods:This prospective study was conducted with 90 patients with myelopathy, both traumatic and non-traumatic (males = 65) in a university tertiary research hospital in India between January 2011 and December 2013. Mean age was 33.5 ± 13.2 years (range 15-65 years), mean duration of injury was 82.63 ± 88.3 days (range 14-365 days) and mean length of stay (LOS) in the rehabilitation unit 42.5 ± 23.3 days (range 14-130 days). The urodynamic study was performed in all the patients to assess the neurogenic bladder pattern. Management was based on the UDS findings. Functional recovery was assessed using Barthel index (BI) scores and spinal cord independence measures (SCIM) scores. Neurological recovery was assessed using ASIA impairment scale (AIS). We tried to correlate neurogenic bladder patterns with recovery.Results:Fifty patients (55.6%) had overactive detrusor with 25 each had detrusor sphincter dyssynergia (DSD) and synergic sphincter. Thirty-eight patients had hypoactive/acontractile detrusor and two had normal studies. No significant correlation observed between neurogenic bladder pattern and change in BI scores (P = 0.696), SCIM scores (P = 0.135) or change in ASIA status (P = 0.841) in the study.Conclusions:More than half of the patients with myelopathies had overactive detrusor with or without dyssynergic sphincter according to the urodynamic study. Neurogenic bladder patterns had no significant correlation with functional and neurological recovery in these patients.

Urodynamic profile in acute transverse myelitis patients: Its correlation with neurological outcome

“…This is not unusual and has been amply documented with most of the nontraumatic myelopathy rehabilitation studies. [141524252627] Similarly, the neurological status showed significant improvement when admission scores were compared with discharge scores ( P < 0.05).…”

“…The analysis of graph and values of relevant pressures was done, the final urodynamic diagnosis was made, and management determined and instituted consisting of pharmacotherapy, supportive and behavioral measures. [14]…”

“…[121314151617] Bladder dysfunction could be one of the most disabling sequelae and shows variable recovery even in cases with complete neurological recovery. [13] The patients may complain of increased frequency, urgency, urge incontinence, or there could be complaints of incomplete evacuation of bladder or straining to void.…”

Urinary Symptoms and Bladder Dysfunction in Patients with Neuromyelitis Optica Spectrum Disorders: Evaluation with Urodynamics and Management

“…Our experience with both traumatic and nontraumatic myelopathies yielded similar results in the past. 19,20 No significant correlation was observed between the neurologic statuses of the patients (AIS) with bladder characteristics based on UDS. This has been observed and reported in the literature while studying patients with long-segment myelitis (transverse myelitis) and trying to observe a "set pattern" or correlation between UDS findings and severity of neurologic lesions (AIS).…”

“…More than half of the patients (22/42) had NDO on UDS with or without dyssynergia, which is on the expected line and has been abundantly reported in the literature in patients with NMOSD. [18][19][20][21] UDS was performed in 23 patients with a first episode of illness and urinary symptoms only when the patients were out of spinal shocklike picture and had more "definitive" bladder dysfunction symptoms such as increased frequency, urgency, or incontinence after 4 to 6 weeks of illness. During the initial phase, the patients have the inability to void, with urinary retention as a predominant complaint.…”