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Acute spinal cord injury: Do ambulatory patients need urodynamic investigations?
MedLine Citation:
PMID:  23069382     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: We sought to compare urodynamic parameters of ambulatory versus non-ambulatory acute spinal cord injured (SCI) patients. PATIENTS & METHODS: A total of 60 patients (mean age 58 years, 27 women and 33 men) suffering from neurogenic lower urinary tract dysfunction (NLUTD) due to acute SCI (duration of injury <40 days) were prospectively evaluated. The patients were dichotomized according to the Mobility for Moderate Distances subscale of the Spinal Cord Independence Measure (SCIM) version III into ambulatory (≥3) and non-ambulatory (<3). Video-urodynamic parameters including maximum detrusor pressure during storage phase, bladder compliance, detrusor overactivity (DO), detrusor external sphincter dyssynergia (DESD), and vesico-uretero-renal reflux were compared between the two groups. RESULTS: Of the 60 acute SCI patients, 17 were ambulatory and 43 non-ambulatory patients, respectively. Mean duration of injury at urodynamic investigation was 30 ± 8 days. The lesion level was cervical in 14, thoracic in 28, lumbar/sacral in 18 patients. Comparing unfavorable urodynamic parameters, no significant differences were found between ambulatory versus non-ambulatory patients: high-pressure system during storage phase (29% versus 33%, p=0.81), low-compliance bladder (12% versus 7%, p=0.54), DO (24% versus 47%, p=0.1), DESD (18% versus 21%, p=0.77), and vesico-uretero-renal reflux (0% versus 5%, p=0.36). CONCLUSIONS: In acute SCI, ambulatory and non-ambulatory patients have a similar risk for unfavorable urodynamic measures. Thus, we strongly recommend the same neuro-urological assessment including urodynamic investigations in all acute SCI patients independent of the walking ability.
Authors:
Carlos H Suzuki Bellucci; Jens Wöllner; Flavia Gregorini; Dorothee Birnböck; Marko Kozomara; Ulrich Mehnert; Martin Schubert; Thomas M Kessler
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-12
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland.
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