Cardiovascular Responses to Bladder and Bowel Distension after Human Spinal Cord Injury

Area of Science:

• Neuroscience
• Cardiovascular Medicine
• Urology

Background:

• Autonomic dysreflexia, triggered by bladder and bowel distention, is a serious concern for individuals with spinal cord injury (SCI).
• Elevated systolic blood pressure (SBP) exceeding 20 mmHg and associated symptoms are common during these triggers.

Purpose of the Study:

• To quantify cardiovascular changes, specifically SBP fluctuations.
• To document the presence and type of symptoms during controlled bladder filling (urodynamics) and bowel distention (anorectal manometry [ARM]) in SCI individuals.

Main Methods:

• 56 participants with SCI (C2-L3, ASIA A-D) underwent filling cystometry (CMG) and ARM on separate days.
• Continuous arterial blood pressure (BP) was monitored throughout both procedures.
• International SCI datasets for bladder and bowel function were collected.

Main Results:

• 90.9% of participants experienced SBP increases >20 mmHg during CMG (mean change: 45 mmHg).
• 85.4% experienced SBP increases >20 mmHg during ARM (mean change: 37 mmHg).
• Symptoms like headache and sweating occurred in 43.6% during CMG and 23.6% during ARM.

Conclusions:

• Urodynamic and bowel assessments in SCI patients frequently trigger significant cardiovascular changes.
• Monitoring BP during these procedures is essential.
• These findings underscore the importance of incorporating BP monitoring into routine SCI management to mitigate health risks.