| Bladder and sphincter behavior in patients with spinal cord lesions. | |
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MedLine Citation:
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PMID: 2056568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To ascertain the relationship between the clinical neurological level, and bladder and sphincter behavior, the video-urodynamic studies of 489 patients with spinal cord lesions due to a variety of causes were retrospectively analyzed. Patients were classified based on the clinical neurological level, etiology of the lesion and presence or absence of signs of sacral cord involvement. Urodynamic findings were classified as either detrusor hyperreflexia, detrusor-external sphincter dyssynergia, detrusor areflexia or normal. The results indicate that although there was a general correlation between the neurological level of injury and the expected vesicourethral function, it was neither absolute nor specific. For example, 20 of 117 cervical cord lesions had detrusor areflexia, 42 of 156 lumbar cord lesions had detrusor-external sphincter dyssynergia and 26 of 84 sacral cord had either detrusor hyperreflexia or detrusor-external sphincter dyssynergia. However, if one considers the presence of neurological abnormalities, 84% of the suprasacral cord lesions with detrusor areflexia have sacral cord signs. In contrast, all suprasacral cord lesions with no evidence of sacral cord involvement have either detrusor hyperreflexia or detrusor-external sphincter dyssynergia. The positive predictive value for positive sacral cord signs and detrusor areflexia was 87%. The positive predictive value for negative sacral cord signs and detrusor hyperreflexia/detrusor-external sphincter dyssynergia was 81%. These data suggest that the clinical neurological examination alone is not an adequate barometer to predict neurourological dysfunction and that video-urodynamic evaluation provides a more precise diagnosis for each patient. |
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Authors:
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S A Kaplan; M B Chancellor; J G Blaivas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of urology Volume: 146 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 1991 Jul |
Date Detail:
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Created Date: 1991-07-26 Completed Date: 1991-07-26 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 113-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Urology, College of Physicians and Surgeons, Columbia-Presbyterian Medical Center, New York, New York. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Child Female Humans Male Middle Aged Neurologic Examination Reflex, Abnormal Spinal Cord Diseases / classification, congenital, diagnosis, physiopathology* Spinal Cord Injuries / classification, diagnosis, physiopathology* Urinary Bladder / physiopathology* Urinary Catheterization Urodynamics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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