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Comparison of cystometric capacities and leak- point intravesical pressures between tetraplegic and paraplegic spinal cord injury patients with neurogenic detrusor overactivity

The aims were to compare cystometric capacities and leak-point intravesical pressures between tetraplegic and paraplegic spinal cord injury patients with neurogenic detrusor overactivity, and to assess eligibility of using suprapubic tapping voiding with external collection device in tetraplegic patients. Filling cystometry at non-physiological filling rate was performed in 122 spinal cord injury patients at rehabilitation or annual check-up using Dantec Etude urodynamic machine. Sixty-seven tetraplegic and 55 paraplegic patients were diagnosed with neurogenic detrusor overactivity, all with suprasacral level of injury. The mean cystometric capacity (CC) was 260±117 mL (range 53-500) in tetraplegic group and 289±135 mL (range 42-530) in paraplegic group. There was no significant between-group difference in CC (P=0.220). The mean leak-point intravesical pressure (Pves LPP) at CC was 72±25 cm H2O (range 25-124) in tetraplegic group and 70±27 cm H2O (range 25-140) in paraplegic group. The difference was not significant (P=0.711). The findings were equally unfavorable in both groups, suggesting the method of suprapubic tapping voiding with external collection device to be no more advisable in tetraplegic than in paraplegic patients. Neurogenic bladder should be managed with the same caution in cervical (tetraplegic) and thoracolumbar (paraplegic) patients, including intermittent catheterization as the first treatment choice, as opposed to the use of the less carer-time-consuming suprapubic tapping voiding with external collection device.

spinal cord injury ; cystometry ; detrusor overactivity ; suprapubic tapping

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