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

Abstract

Objective:The objective of this study was to observe urodynamic profile of acute transverse myelitis (ATM) patients and its correlation with neurological outcome.Patients and Methods:This prospective study was conducted in the neurorehabilitation unit of a tertiary university research hospital from July 2012 to June 2014. Forty-three patients (19 men) with ATM with bladder dysfunction, admitted in the rehabilitation unit, were included in this study. Urodynamic study (UDS) was performed in all the patients. Their neurological status was assessed using ASIA impairment scale and functional status was assessed using spinal cord independence measure. Bladder management was based on UDS findings.Results:In total, 17 patients had tetraplegia and 26 had paraplegia. Thirty-six patients (83.7%) had complaints of increased frequency and urgency of urine with 26 patients reported at least one episode of urge incontinence. Seven patients reported obstructive urinary complaints in the form of straining to void with 13 patients reported both urgency and straining to void and 3 also had stress incontinence. Thirty-seven (86.1%) patients had neurogenic overactive detrusor with or without sphincter dyssynergia and five patients had acontractile detrusor on UDS. No definitive pattern was observed between neurological status and bladder characteristics. All patients showed significant neurological and functional recovery with inpatient rehabilitation (P < 0.05 and P < 0.001, respectively).Conclusions:The problem of neurogenic bladder dysfunction is integral to ATM. Bladder management in these patients should be based on UDS findings. Bladder characteristics have no definitive pattern consistent with the neurological status.

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

“…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). 16,22 This study underlines the importance of performing UDS in all NMOSD patients irrespective of the extent of sensorimotor recovery for the management of LUTS as the patients can have both LMN and UMN types of bladder, which can only be understood clearly with a properly written bladder diary and objectively by doing UDS.…”

“…All definitions used were in accordance with the International Continence Society Report. 16,17 Filling cystometry was performed with patients in the supine position on the urodynamic table. Bladder filling performed with normal saline at medium fill rate (10-50 mL/minute).…”

“…Patients were advised management based on UDS findings, which included pharmacotherapy, and supportive and behavioral measures. 16,18…”

Urinary symptoms in patients with Parkinson's disease and progressive supranuclear palsy: Urodynamic findings and management of bladder dysfunction

“…The complete data were captured, and analysis of graph and values of relevant pressures was done. [2021] The final urodynamic diagnosis was made, and management determined and instituted consisting of pharmacotherapy, supportive and behavioral measures.…”

Catheter induced hypospadias, urethral trauma and penile abscess in completely recoverable neurological afflictions: preventable entities

“…Lower urinary tract evaluation is also deferred in those patients making quick recovery otherwise bladder management in these patients should be based on UDS findings as bladder characteristics have no definitive pattern consistent with the neurological status. 18 It should be performed as baseline following passage of spinal shock and return of spinal reflexes to classify bladder type and to guide decision making regarding the method of bladder management. Subsequently annual, biannual or periodic UDS are performed depending upon the change in symptoms and the risk of upper tract deterioration which can be picked up on Ultrasound as it does not expose patients to radiation.…”