The description of urodynamic study for bladder dysfunction in compressive myelo- or radiculo-pathy: A prospective study in an institutional setup

Nayil Khursheed; Bilal Pahalwan; Humam Nisar; Altaf Ramzan; Saleem Wani; Abrar Wani; Sarbjit Singh; Rouf Khawaja; Arif Hamid; Hussain Arif; Baldev Singh

doi:10.4103/ajns.AJNS_173_16

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 828-833
DOI: 10.4103/ajns.AJNS_173_16

Original Article

The description of urodynamic study for bladder dysfunction in compressive myelo- or radiculo-pathy: A prospective study in an institutional setup

Nayil Khursheed

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Bilal Pahalwan

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Humam Nisar

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Altaf Ramzan

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Saleem Wani

¹Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Abrar Wani

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Sarbjit Singh

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Rouf Khawaja

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Arif Hamid

¹Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Hussain Arif

Department of Neurosurgery, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

,

Baldev Singh

¹Department of Urology, Sher-i-Institute of Medical Sciences, Srinagar, Jammu and Kashmir

› Author Affiliations

Abstract

Purpose: To study the significance of filling cystometry with pressure flow studies and bladder electromyography (EMG) in assessment and management of neurogenic bladder with myelopathies and evaluated neurological recovery in the follow-up period. Methods: The study was a 3-year prospective urodynamic study in 63 patients, with traumatic and nontraumatic myelopathy. Bladder management was advised based on the cystometric findings. Neurological recovery and mode of bladder management were evaluated during follow-up after a minimum of 6 months. Results: Mean age was 44.6 years (range 10–80 years). Thoracolumbar area was most commonly involved. Cystometry revealed overactive detrusor in 46 patients, (17 had detrusor sphincter dyssynergia [DSD], 29 without DSD) and areflexic/underactive detrusor in 9 patients. Postvoid residual (>15% of voided urine) was significant in 27 patients. Neurological recovery was seen in 60.3%, whereas 22.2% showed no improvement (partial improvement in 4.8%) and 12.6% had normal bladder function both initially and at follow-up. Correlation between neurological recovery and bladder management was found to be insignificant (P > 0.05) using spearman's correlation coefficient. Conclusion: Filling cystometry with pressure flow studies and EMG study is valuable for the assessment and management of neurogenic bladder in patients with myelopathy. In neurogenic bladder management and follow-up, pressure flow studies help to prevent complications and upper urinary tract complications.

Key-words:

Compressive myelopathy - filling cystometry - neurogenic bladder - radiculopathy - spinal injury - urodynamic study

Full Text

References

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