Document Detail

Pressor response during cystomanometry in spinal injury patients complicated with detrusor-sphincter dyssynergia.
MedLine Citation:
PMID:  37349     Owner:  NLM     Status:  MEDLINE    
Herein attention is focused on the documentation of high blood pressure response with detrusor-sphincter dyssynergia in spinal cord injury patients and with its amelioration after extended sphincterotomy. During cystomanometric evaluation of the bladder the monitored blood pressure response in 53 spinal injury patients, 27 non-dyssynergic spinal injury patients and 18 non-spinal injury patients was compared. A high correlation was observed among the magnitudes of blood pressure increase, level of injury and the severity of detrusor-sphincter dyssynergia in spinal injury patients. During cystomanometry blood pressure increases of greater than 20 mm. Hg systolic and 10 mm. Hg diastolic in normotensive paraplegics (below T5) and also in non-spinal injury patients were significant to suspect detrusor-sphincter dyssynergia. In normotensive tetraplegic patients blood pressure increases of greater than 40 mm. Hg systolic and 20 mm. Hg diastolic were significant to suspect detrusor-sphincter dyssynergia. The mechanism of blood pressure increase is elucidated. The management of this high blood pressure response in patients with detrusor-sphincter dyssynergia by drug therapy and extended sphincterotomy is discussed. Based on our experience the use of carbon dioxide for cystomanometry seems preferable in patients with spinal lesions above T5 since expedient deflation of the bladder can prevent an inordinate blood pressure increase.
I Perkash
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  121     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1979 Jun 
Date Detail:
Created Date:  1979-09-25     Completed Date:  1979-09-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  778-82     Citation Subset:  AIM; IM    
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MeSH Terms
Adrenergic alpha-Antagonists / pharmacology
Blood Pressure* / drug effects
Carbon Dioxide
Manometry / adverse effects*
Middle Aged
Paraplegia / physiopathology
Quadriplegia / physiopathology
Reflex, Abnormal / complications
Spinal Cord Diseases / complications
Spinal Cord Injuries / physiopathology*
Urinary Bladder / physiopathology*
Urinary Bladder, Neurogenic / etiology,  physiopathology*,  surgery
Reg. No./Substance:
0/Adrenergic alpha-Antagonists; 124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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