AbstractAim: The purpose of this study was to investigate the association between the detrusor muscle function and thelevel of the spinal cord injury.Material & Methods: An observational study including 50 patients was conducted in the Department of Urology,ESICMCH, Bihta, Patna, Bihar, India . Written informed consent was obtained from all participants.Results: There was a total of 50 individuals with traumatic SCI, of whom 25 (50%) had cervical injury, 12 (24%)had thoracic injury, 8 (16%) had lumbar injury, and 5 (10%) had sacral vertebral injury. Among these individuals,29 had neurologically complete injuries and 21 incompletes (according to ASIA) at the time of examination.All but one cervical patient with DO and detrusor sphincter dyssynergia were negative for sacral cord lesion. Onlyone of the 12 patients with thoracic-level injuries had normal urodynamic findings and sacral cord lesion, whereasnone of the patients had detrusor areflexia. None of the 8 patients with lumbar cord injuries with DO and detrusorsphincter dyssynergia had positive sacral cord lesion, whereas all four patients with detrusor areflexia werepositive for sacral cord lesion. Low bladder compliance was seen in 15 cases with DO, 14 cases with detrusorsphincter dyssynergia, while in only four cases with detrusor areflexia and one with normal bladder. Most of thepatients with suprasacral cord lesions had high detrusor leak point pressures.Conclusion: Bladder function differs according to the level of injury. It is, therefore, important to define theneurological lesion to appreciate the voiding dysfunction and thereby to develop an appropriate managementplan for long-term urologic care. Bladder management should be directed towards protection of upper tracts,prevention of infection, autonomic dysreflexia, and encouraging bladder emptying at low pressures, as the firstand foremost goal. Despite consistent data regarding classic voiding dysfunction with complete injuries,multiplicity of injury may contribute to complicated urodynamic findings. Therefore, urodynamic evaluation iscrucial to correctly identify the type of voiding dysfunction and to optimize long-term management.

AbstractAim: The purpose of this study was to investigate the association between the detrusor muscle function and thelevel of the spinal cord injury.Material & Methods: An observational study including 50 patients was conducted in the Department of Urology,ESICMCH, Bihta, Patna, Bihar, India . Written informed consent was obtained from all participants.Results: There was a total of 50 individuals with traumatic SCI, of whom 25 (50%) had cervical injury, 12 (24%)had thoracic injury, 8 (16%) had lumbar injury, and 5 (10%) had sacral vertebral injury. Among these individuals,29 had neurologically complete injuries and 21 incompletes (according to ASIA) at the time of examination.All but one cervical patient with DO and detrusor sphincter dyssynergia were negative for sacral cord lesion. Onlyone of the 12 patients with thoracic-level injuries had normal urodynamic findings and sacral cord lesion, whereasnone of the patients had detrusor areflexia. None of the 8 patients with lumbar cord injuries with DO and detrusorsphincter dyssynergia had positive sacral cord lesion, whereas all four patients with detrusor areflexia werepositive for sacral cord lesion. Low bladder compliance was seen in 15 cases with DO, 14 cases with detrusorsphincter dyssynergia, while in only four cases with detrusor areflexia and one with normal bladder. Most of thepatients with suprasacral cord lesions had high detrusor leak point pressures.Conclusion: Bladder function differs according to the level of injury. It is, therefore, important to define theneurological lesion to appreciate the voiding dysfunction and thereby to develop an appropriate managementplan for long-term urologic care. Bladder management should be directed towards protection of upper tracts,prevention of infection, autonomic dysreflexia, and encouraging bladder emptying at low pressures, as the firstand foremost goal. Despite consistent data regarding classic voiding dysfunction with complete injuries,multiplicity of injury may contribute to complicated urodynamic findings. Therefore, urodynamic evaluation iscrucial to correctly identify the type of voiding dysfunction and to optimize long-term management.