Original scientific paper
Relation of neurological level of spinal cord injury to cystometric findings in patients with neurogenic detrusor overactivity
Saša MOSLAVAC
orcid.org/0000-0002-5327-0050
; Specijalna bolnica za medicinsku rehabilitaciju, Varaždinske Toplice
Abstract
Abstract
Aim: to check the relation of level of spinal cord injury (SCI) to findings of
cystometric capacity (CC) and leak-point intravesical pressure (Pves) in patients
with neurogenic detrusor overactivity.
Patients and methods: cystometric findings in four functionally or neurologically
relevant SCI levels were compared: cervical (C1–C8), thoracic (T1–T9), thoraciclumbar
(T10–L2) and lumbar (L3–L5), in rehabilitation department for SCI patients
of Special Medical Rehabilitation Hospital in Varaždinske Toplice. Patients` age, time
from injury and the neurological level of injury measured by Standard neurological
classification of SCI were noted. CC (in ml) and Pves (in cmH20) were measured
in patients with stabilized neurological and urological deficit. Values are presented
as average and standard deviation, and Kruskal-Wallis test was used to assess
differences among groups. The level of significance was set to α= 0.05.
Results: 180 male patients with traumatic suprasacral SCI and neurogenic detrusor
overactivity at cystometry were included in the study. 97 patients were in cervical,
40 in thoracic, 36 in thoracic-lumbar and 7 in lumbar group. The average age at
injury was 39 ± 17 years (range 12 – 75, median 36 years). The average time
from injury to cystometry was 674 ± 1285 days (range 16 – 10065 days, median
164). Finding of CC and Pves in groups were: cervical – 279 ± 127 ml, 69 ± 25
cmH20, thoracic – 294 ± 128 ml, 73 ± 26 cmH20, thoracic-lumbar – 288 ± 139 ml,
73 ± 24 cmH20, lumbar – 412 ± 112 ml, 55 ± 28 cmH20. There were no significant
differences between CC (P = 0.081) and Pves (P = 0.451) among four groups, nor
in the first three groups (cervical, thoracic, and thoracic-lumbar) (P = 0.799 and P
= 0.744).
Conclusion: There were no differences in typical findings of CC and Pves in specified
groups of levels of injury, and in all groups there were patients with unfavourable
findings of reduced CC and increased Pves that endanger upper urinary system.
Therefore micturition programme must be based on individual cystometric findings.
Keywords
spinal cord injury; neurogenic detrusor overactivity; cystometry
Hrčak ID:
125656
URI
Publication date:
28.7.2014.
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