N
Bladder capacity (ml)
Bladder pressure (KPa)
Urethral pressure (KPa)
Residual volume (ml)
Urine culture (+)
Urine return
Urinary tract infection
Renal damage
A
6
300 ± 100
7 ± 2
6 ± 1
40 ± 10
0
0
1 (16 %)
0
B
5
300 ± 100
7 ± 2
6 ± 1.5
50 ± 10
3
0
1 (20 %)
0
C
13
150 ± 100
9 ± 3
8 ± 1.5
100 ± 30
25
4
7 (55 %)
5 (38 %)
D
12
500 ± 200
4 ± 1
4 ± 1.5
200 ± 100
31
0
10 (83 %)
1 (8.3 %)
1.
Bladder volume pressure curve: the results of Groups A and B are close to normal and there were very few reflected waves. The slope of Group C increased, and the curve shifted left. There were many reflected waves. Group D had very flat curve that shifted right, and there was no reflected wave.
2.
Detrusor reflection: Groups A and B had hyperreflexia, Group C had obvious hyperreflexia and Group D had no hyperreflexia.
3.
Bladder compliance: Groups A and B were close to normal. Group C had low compliance, while Group D had high compliance.
4.
Electromyography of the detrusor and sphincter: The detrusor and sphincter harmonized with each other in Groups A and B while they were inharmonious in Group C. The detrusor and sphincter were unrelated with each other in Group D.
The test results showed that urodynamic performance varies according to the different site and degree of spinal cord injury. Different urodynamic performance leads to different bladder function and complications. In this regard, the urodynamic classification of the bladder is very important to the prevention and treatment of complications, as well as the improvement and recovery of bladder function.
3.4 Discussion
Clinical manifestation of the bladder after spinal cord injury is complicated, and there are many ways of classification. Turner-Warwick is a frequently used method that classifies patients’ bladder into detrusor hyperreflexia and detrusor areflexia.
After systematic urodynamic examination, we found that bladder function is determined by three factors: (1) detrusor reflex contraction function; (2) urethral sphincter contraction function; (3) cooperation between the detrusor and sphincter. Factor 3 is especially vital to the maintenance of normal urination. Therefore, the author divided bladders after spinal cord injury into the following three classes based on Turner-Warwick:
1.
Reconstruction of Bladder Innervation Above the Level of Spinal Cord Injury for Inducing Urination by Abdomen-to-Bladder Reflex Contractions
Reconstruction of Bladder Innervation Below the Level of Spinal Cord Injury for Inducing Urination by Achilles Tendon-to-Bladder Reflex Contractions
Pathological Changes in the Detrusor After Spinal Cord Injury
Clinical Anatomy of Cauda Equina and Lumbosacral Nerve Root
Transfer of Normal Lumbosacral Nerve Roots to Reinnervate Atonic Bladder
Microstructural Study of the Detrusor Muscle After Repair of Atonic Bladders Caused by Injury to the Medullary Cone in Rats
Bladder with detrusor hyperreflexia and coordinating sphincter;
Related posts:
Reconstruction of Bladder Innervation Above the Level of Spinal Cord Injury for Inducing Urination by Abdomen-to-Bladder Reflex Contractions
Reconstruction of Bladder Innervation Below the Level of Spinal Cord Injury for Inducing Urination by Achilles Tendon-to-Bladder Reflex Contractions
Pathological Changes in the Detrusor After Spinal Cord Injury
Clinical Anatomy of Cauda Equina and Lumbosacral Nerve Root
Transfer of Normal Lumbosacral Nerve Roots to Reinnervate Atonic Bladder
Microstructural Study of the Detrusor Muscle After Repair of Atonic Bladders Caused by Injury to the Medullary Cone in Rats
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