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Int Neurourol J > Accepted Articles
DOI: https://doi.org/10.5213/inj.2142026.013    [Accepted]
Sensations Reported During Urodynamic Bladder Filling in Spinal Cord Injury Patients Give Additional Important Information
Jean-Jacques Wyndaele1, Michel Wyndaele2, Peter F.W.M. Rosier2
1Faculty GGW, University Antwerp, Brasschaat, Belgium
2Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
Correspondence  Jean-Jacques Wyndaele ,Email: wyndaelejj@skynet.be
Submitted: 29 December 2020;  Accepted after revision: 11 February 2021.
ABSTRACT
Purpose
To study sensations reported during filling cystometry in patients with different levels and completeness of spinal cord lesion (SCL).
Methods
A retrospective cohort study. Patient age and sex, cause of SCL, American Spinal Injury Association Impairment Scale (AIS), and lower urinary tract -related sensations in daily life were gathered. Filling cystometry (video-urodynamics) was performed following ICS good urodynamic practice guidelines. Beside bladder filling sensations (first sensation of bladder filling, first desire to void, strong desire to void), other sensations as detrusor overactivity related sensation and pain were noted.
Results
170 patients were included, age 45 ± 17 years, 114 male and 56 female, 92 complete and 78 incomplete SCL. The test was done 6 ± 4 years post SCL. Sensation was reported by 57% of all patients. In complete SCL half (46/92) had sensation, while 36% with incomplete SCL (28/78) reported no sensation. Bladder awareness was not predictable by the AIS. The filling sensations reported were equal to those given in the terminology of ICS. Pain was seldom present 10/170 (6%), Detrusor overactivity contraction was felt by 45/78 ( 58%). Very few patients used sensory information for bladder management at home.
Conclusion
After SCL, most patients retain the ability to be aware of the LUT, assessable and gradable, during urodynamic testing. Filling sensations were not different from those described in healthy, but the number and sequence of the sensations were altered in the minority. Pain and sensation of unstable contractions gave additional important information. As different sensations relate to different spinal afferent pathways, the sensory evaluation during cystometry provided additional important information on the spinal cord's condition.
Keywords: Bladder sensation; Filling cystometry; Spinal cord lesion; Sensory pathways
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Official Journal of Korean Continence Society & ESSIC (International Society for the Study of BPS) & Korean Society of Urological Research & The Korean Children’s Continence and Enuresis Society & The Korean Association of Urogenital Tract Infection and Inflammation & Korean Society of Geriatric Urological Care
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