Urodynamic evaluation in spinal cord injuries

Spinal cord injury, regardless of its level, causes flaccid paralysis during the shock phase affecting the detrusor and rectal musculature. Then, depending on the level and severity of the lesion, the bladder gains spasticity or remains flaccid. Monitoring the reflex behaviour of detrusor and sphincter activities helps to select the treatment modalities. Thirty patients with cord injuries of various levels have been urodynamically tested at 3-month intervals. The shock phase of the acutely tested patients lasted about 8-9 weeks. Eventually, 23 of the cases were hyperreflexic, while 7 cases remained areflexic: 2 had detrusor-sphincter dyssynergia. The response to treatment has been investigated by cystometrographical and electromyographical methods.