Urodynamic Differences between Complete and Incomplete Spinal Cord Injuries with Neurogenic Detrusor Overactivity

Area of Science:

• Urology
• Neuroscience
• Rehabilitation Medicine

Background:

• Neurogenic detrusor overactivity (NDO) is a common complication of spinal cord injury (SCI).
• The American Spinal Injury Association (ASIA) classification distinguishes between complete and incomplete SCI.
• Urodynamic parameters may differ based on SCI severity.

Purpose of the Study:

• To investigate urodynamic differences in patients with NDO secondary to SCI.
• To compare urodynamic findings between complete (ASIA A) and incomplete (ASIA B-E) SCI.

Main Methods:

• Retrospective analysis of 194 patients with suprasacral SCI and NDO.
• Evaluation of Maximum Cystometric Capacity (MCC), Volume at First Involuntary Contraction (VIC), compliance, Maximum Detrusor Pressure (MaxDetP), Detrusor Leak Point Pressure (LeakDetP), and Postvoid Residual urine volume (PVR).
• Statistical comparison using Student t-test (p < 0.05).

Main Results:

• Incomplete SCI (ASIA B-E) was observed in 73.7% of patients, complete SCI (ASIA A) in 26.3%.
• Significant differences were found in MCC (321.6 ± 127.1 mL in ASIA B-E vs. 278.5 ± 102.6 mL in ASIA A; p=0.018) and VIC (210 ± 114.4 mL in ASIA B-E vs. 161 ± 85.1 mL in ASIA A; p=0.006).
• No significant differences were noted for MaxDetP, LeakDetP, PVR, or compliance.

Conclusions:

• Incomplete SCI (ASIA B-E) is associated with distinct MCC and VIC compared to complete SCI (ASIA A).
• Urodynamic parameters like LeakDetP, MaxDetP, PVR, and compliance do not significantly differ between complete and incomplete SCI in this cohort.
• These findings suggest that SCI completeness influences specific bladder storage characteristics in NDO patients.