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Related Experiment Videos

Autonomic hyperreflexia revisited

B Schurch1, P A Knapp, A B Rossier

  • 1Swiss Paraplegic Centre, University Hospital Balgrist, Zürich, Switzerland.

Urologia Internationalis
|January 1, 1997
PubMed
Summary
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Autonomic hyperreflexia (AHR) in high spinal cord injury patients is linked to neurogenic bladder. Posterior urethral receptors play a key role in maintaining AHR during micturition.

Area of Science:

  • Urology
  • Neurology
  • Physiology

Background:

  • High spinal cord injury (SCI) can lead to neurogenic bladder dysfunction.
  • Autonomic hyperreflexia (AHR) is a potentially life-threatening complication in SCI patients.
  • Understanding AHR triggers is crucial for patient management.

Purpose of the Study:

  • To analyze autonomic hyperreflexia (AHR) in patients with neurogenic bladder dysfunction after high spinal cord injury.
  • To investigate the relationship between urodynamic phases and mean arterial pressure (MAP) changes during AHR.
  • To identify specific factors contributing to AHR during micturition.

Main Methods:

  • Utilized a novel recording system to examine 65 patients with spinal cord lesions above T5-T6.
  • Focused on 17 patients presenting with neurogenic voiding disorders and AHR.

Related Experiment Videos

  • Analyzed mean arterial pressure (MAP) changes during bladder filling, isometric contraction, and voiding in 11 study participants.

    • Main Results:

    • Nine of eleven patients exhibited uninhibited bladder contractions and voiding, with progressive MAP increases during contraction and voiding.
    • MAP returned to baseline within 5 minutes post-micturition in these nine patients.
    • Two patients with detrusor-sphincter dyssynergia showed maximal MAP occurring earlier, before or at maximal bladder pressure, with subsequent decreases.

    Conclusions:

    • Posterior urethral receptors and their ascending pathways are implicated in maintaining AHR during micturition.
    • Urodynamic findings suggest distinct AHR patterns based on voiding efficiency.
    • Further research into receptor pathways can inform AHR management strategies.