[Urodynamic and neurophysiological evaluation of lower urinary tract dysfunction after gunshot spinal cord injury]

To characterize urodynamic disorders of the lower urinary tract (LUT) and neurophysiological abnormalities in patients with gunshot spinal cord injury (SCI) during the first year after injury.

In this single-center cohort study, 41 male patients with suprasacral gunshot spinal cord injury (SCI) and neurogenic LUT dysfunction were evaluated during the first year after injury. The mean age at hospitalization was 35 years±9 months (range: 18-55 years). Comprehensive urodynamic and neurophysiological assessments were performed. Clinical and urodynamic outcomes following intradetrusor botulinum toxin administration for detrusor overactivity were also analyzed.

Detrusor overactivity was identified in 27.5-31.3% of cases within the first 6 months after spinal cord injury, increasing to 78.5% between 6 and 12 months post-injury. No significant differences in the frequency of urodynamic disorders were observed between patients with complete (ASIA scale grade A) and incomplete (ASIA scale grades B-D) spinal cord injury. No correlation was found between LUT urodynamic abnormalities of neurogenic bladder and neurophysiological test results. Intradetrusor administration of botulinum toxin in patients with detrusor overactivity increased cystometric capacity to 288.3±90.0 mL and reduced detrusor pressure to 54.5±20.7 cm H₂O. It also reduced urinary incontinence episodes to 3.6±3.3 per day.

The results show a higher incidence of detrusor overactivity during 6-12 months after injury. No correlation was found between LUT urodynamic disorders and neurophysiological examination results. No correlation was found between the results of neurophysiological tests and the comprehensive urodynamic examination. The small sample size limits these conclusions, and further research with larger cohorts is needed.