Significance of low compliance bladder in cauda equina injury

Shin, Ji Cheol; Ci, Park; Kim, Hyung Jun; Iy, Lee

doi:10.1038/sj.sc.3101380

Cited by 22 publications

(13 citation statements)

References 31 publications

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“…Literatürde, OY'li hastalarda nörojenik mesane tipi ile ilişkili faktörlerin değerlendirildiği çalışma sayısı az olup, veriler sonuçlarımız ile uyumludur (26 arasında pozitif korelasyon olduğu saptanmış olup, daha önceki çalışma sonuçları ile uyumlu bulunmuştur (26). Aynı çalışmada, düşük mesane kompliyansı olan grupta MCC'nin daha düşük olduğu da bildirilmiştir.…”

Section: Discussionunclassified

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Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

Yıldız¹,

Alkan²,

Akkaya³

et al. 2011

Tftr

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Objective: It was aimed to investigate the relationship of lesion level and severity with bladder behavior based on urodynamic findings in patients with spinal cord injury (SCI). Materials and Methods: Forty nine patients who were on inpatient rehabilitation programme in our clinic with the diagnosis of SCI after the spinal shock period were included in the study. Neurological level (cervical, thoracal, lumbosacral) and severity of the lesion (complete, incomplete) were set according to the American Spinal Injury Association (ASIA) classification. It was assessed if the level and severity of the SCI related to neurogenic bladder type, maximum cystometric capacity (MCC) and compliance which were designated with urodynamic study and methods of bladder management. Results: There was no difference in terms of age, sex, disease duration, neurogenic bladder type, MCC, compliance, method of bladder management on admission according to the level and severity of the lesion among patients with SCI (p>0.05).Level and severity of SCI were significantly associated with the method of bladder drainage at discharge (r: 0.33, p<0.01 and r: 0.40, p<0.005, respectively). 90.5% of patients with complete SCI and 64.3% of patients with incomplete SCI were using clean intermittent catheterization (CIC), 32.1% of the patients with incomplete SCI urinated spontaneously, whereas none of the patients with complete SCI could urinate. It was found that 83.3% of cervical, 81.8% of thoracic and 60% of lumbosacral injured patients were using CIC. The greatest rate of spontaneous urination (40%) was observed in people with lumbosacral injuries compared to cervical and thoracic levels (8.3 and 9.1%, respectively).The significance of this difference could not be tested statistically due to the small sample size. Level (r: 0.33) and severity (r: 0.40) of SCI, MCC (r: 0.33) and compliance (r: 0.34) were all significantly correlated with the method of bladder management at discharge. Conclusion: MCC, compliance, and level and severity of injury were found to be related with the method of bladder management at discharge in patients with SCI. On the other hand, when the lesion level and severity are insufficient in determining the bladder behavior, the necessity of urodynamical evaluation arises. Turk J Phys Med Re hab 2011;57:206-11. Key Words: Spinal cord injury, neurogenic bladder, bladder behavior Özet Amaç: Omurilik yaralanmalı (OY) hastalarda lezyon seviyesi ve ciddiyeti ile ürodinamik bulgulara dayalı mesane davranışı arasındaki ilişkiyi araştırmak amaçlandı. Gereç ve Yöntem: OY tanısı ile kliniğimizde yatarak rehabilitasyon programı uygulanan, spinal şok döneminden çıkmış, 49 hasta çalışmaya dahil edildi. American Spinal Injury Association (ASIA) sınıflamasına göre, nörolojik lezyon seviyesi (servikal, torakal, lumbosakral) ve ciddiyeti (komplet, inkomplet) belirlendi. OY seviyesi ve ciddiyeti ile ürodinamik çalışma ile belirlenen nörojenik mesane tipi, maksimum sistometrik kapasite (MCC), kompliyans ve mesane boşaltım yöntemleri arasındaki ...

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Section: Discussionunclassified

“…Aynı çalışmada, düşük mesane kompliyansı olan grupta MCC'nin daha düşük olduğu da bildirilmiştir. Literatürde, OY'li hastalarda mesane boşaltım yöntemini etkileyen faktörleri değerlendiren çok az çalışma mevcuttur (8,26,27). Rapidi Kay nak lar…”

Section: Discussionunclassified

Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

Yıldız¹,

Alkan²,

Akkaya³

et al. 2011

Tftr

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“…1 This study demonstrated that not all patients with discomplete SCIs accepted the use of sensation-dependent bladder emptying. However, the use of sensation-dependent bladder emptying will be determined based on the results of urodynamic studies if patients with discomplete SCIs express the desire to void.…”

Section: Discussionmentioning

confidence: 99%

The determination of sensation-dependent bladder emptying time in patients with complete spinal cord injury above T11

et al. 2007

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Study design: Retrospective investigation using urodynamic studies and medical records. Objective: To evaluate the safety of sensation-dependent bladder emptying in complete spinal cord injury (SCI) patients, based on the preservation of the desire to void. Setting: Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. Methods: This study was performed retrospectively on 79 complete SCI patients with lesions above T11, who had preserved the desire to void during conventional urodynamic studies. Patients were classified according to detrusor compliance and maximal bladder capacity. The clinical and urodynamic characteristics of each group were analyzed. Results: Forty-five (57.0%) patients were classified as group A and 34 (43.0%) patients were classified as group B. There were no significant differences in clinical features, such as voiding methods and the presence of autonomic dysreflexia between the two groups. Compared with group B, there were significantly more areflexic neurogenic bladder cases in group A (Po0.05). There were significantly higher maximal detrusor pressures in group B (Po0.05). There were significantly more cases with the preservation of the strong desire to void in group B (Po0.05). Conclusion: Not all patients with discomplete SCIs accepted the use of sensation-dependent bladder emptying. The safe use of sensation-dependent bladder emptying will be determined based on the results of urodynamic studies.

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“…A recent study also revealed that voiding dysfunction depends on the level of cord injury [19] . Furthermore, a prospective study demonstrated the association of cauda equina injury with low compliance of the bladder [20] . The present study showed that there was a close relationship between LUTS and cauda equina symptoms.…”

Section: Commentmentioning

confidence: 99%

Cauda Equina Symptoms Are Closely Related to Male Lower Urinary Tract Symptoms

Imai¹,

Yamamoto²,

Iwabuchi³

et al. 2010

Urol Int

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Introduction: To determine the impact of cauda equina symptoms on male lower urinary tract function, we investigated the related risk factors in healthy Japanese men. Methods: Subjects included 345 healthy males (average age 56 years; range 26–83) who participated in the Iwaki Health Promotion Project in 2006. They were residents of Iwaki district, Hirosaki City, northern Japan. Using a self-administered, self-reported questionnaire for lumbar spinal stenosis and International Prostate Symptom Score (IPSS), we investigated the prevalence of cauda equina symptoms. We also measured body mass index; blood pressure; and triglyceride, cholesterol, glucohemoglobin, and prostate-specific antigen levels. Results: Nineteen participants (5.5%) were positive for cauda equina symptoms; 270 participants (78.3%) scored 0–7 points on the total IPSS survey, 65 (18.8%) scored 8–19, and 10 (2.9%) scored 20–35. The total IPSS, and storage and voiding symptom scores of participants negative for cauda equina symptoms were significantly lower than those who were positive. Multiple logistic regression analysis revealed that age and cauda equina symptoms were independent significant risk factors for total IPSS and storage symptoms. Conclusions: Cauda equina symptoms are closely related to lower urinary tract symptoms in healthy Japanese men.

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Significance of low compliance bladder in cauda equina injury

Cited by 22 publications

References 31 publications

Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

Omurilik Yaralanmalı Hastalarda Lezyon Seviyesi ve Ciddiyeti ile Mesane Davranışı Arasındaki İlişki

The determination of sensation-dependent bladder emptying time in patients with complete spinal cord injury above T11

Cauda Equina Symptoms Are Closely Related to Male Lower Urinary Tract Symptoms

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