Patterns of bladder recovery in spinal injury evaluated by serial urodynamic observations

The results of serial urodynamic studies in spinal cord injury are presented. A number of signs which may be useful in the prediction of patients who will eventually establish spontaneous and satisfactory voiding are described. (1) Some patients with cervical high/thoracic lesions show evidence of synchrony between the external sphincter and the detrusor muscle in the phase of spinal shock. Spontaneous and efficient voiding usually occurs in this group. (2) Some patients, especially those with mild-thoracic lesions show marked dyschrony between the external sphincter/detrusor muscle in the phase of spinal shock. Early outlet surgery is indicated in this group since spontaneous and efficient voiding rarely occurs. (3) A zone of high pressure can be detected in the posterior urethra in the phase of spinal shock often within the first week after injury.