Relationship of Bladder Function with Toe Position Sense, Neurological Level, Lesion Severity, and Bulbocavernosus Reflex in Patients with Spinal Cord Injury

Abstract

Objective: Examination of the relationship among toe position sense (TPS), neurological level (cervical, thoracic, lumbosacral), severity of the lesion (complete, incomplete), bulbocavernosus reflex (BCR), and bladder behavior in patients with spinal cord injury (SCI). Material and Methods: Fifty-nine patients with SCI were included in the study. Patient characteristics, TPS, and BCR were recorded. Neurological level and lesion severity were determined according to the American Spinal Injury Association Impairment Scale (AIS) classification. Maximum cystometric capacity (MC), storage and emptying function, type of detrusor (overactive, acontractile-underactive), spontaneous voided urine volume (SVU), and post-void residual urine volume (PVR) values were established performing the urodynamic study. Results: Neurological level, lesion severity, TPS, and BCR were not significantly correlated with storage dysfunction, emptying dysfunction, type of detrusor, MC, and PVR (p>0.05). SVU was significantly lower in patients without TPS than in patients with TPS and in complete lesions than in incomplete lesions (p<0.05). Conclusion:The presence of TPS could be a predictive finding in terms of SVU. We can say that neurological level, lesion severity, and BCR are not adequate parameters to predict bladder dysfunction; therefore, urodynamic evaluation is necessary for each patient with SCI.