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Related Experiment Videos

Carbon dioxide cystometry and postural changes in patients with multiple sclerosis.

M S Weinstein1, D D Cardenas, E J O'Shaughnessy

  • 1Department of Rehabilitation Medicine, University of Washington, Seattle.

Archives of Physical Medicine and Rehabilitation
|November 1, 1988
PubMed
Summary

Carbon dioxide cystometry accurately assesses bladder function in multiple sclerosis (MS) patients. Positional changes, especially standing, can reveal hyperreflexia not seen in supine tests, aiding treatment decisions.

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Area of Science:

  • Urology
  • Neurology
  • Medical Imaging

Background:

  • Multiple sclerosis (MS) frequently causes bladder dysfunction.
  • Accurate assessment of detrusor muscle response is crucial for managing MS-related bladder issues.
  • Current diagnostic methods may not fully capture positional effects on bladder function.

Purpose of the Study:

  • To evaluate the efficacy of carbon dioxide cystometry in assessing detrusor responses in multiple sclerosis patients.
  • To determine the impact of positional changes (supine, sitting, standing) on bladder function assessment.
  • To compare carbon dioxide cystometry with water cystometry for evaluating bladder responses.

Main Methods:

  • Ninety-one multiple sclerosis patients underwent carbon dioxide cystometry in supine, sitting, and standing positions.

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  • Water cystometry was performed in the supine position for comparison.
  • Detrusor responses were classified as normal, hyperreflexic, or areflexic.

    • Main Results:

    • Carbon dioxide and water cystometry yielded similar results in classifying detrusor responses.
    • Positional changes, particularly standing, reclassified normal supine responses as hyperreflexic.
    • Hyperreflexia worsened in sitting and standing positions; areflexia did not convert to hyperreflexia with positional changes.
    • Dyssynergic sphincter responses were infrequent, suggesting early-stage MS in this cohort.

    Conclusions:

    • Carbon dioxide cystometry with positional changes is a safe, easy, and accurate method for evaluating detrusor responses in MS patients.
    • Positional testing is vital for uncovering hyperreflexia missed in supine assessments.
    • This method is particularly useful for MS patients with changing clinical courses or treatment resistance.