Urodynamic Differences between Complete and Incomplete Spinal Cord Injuries with Neurogenic Detrusor Overactivity.

OBJECTIVE

To analyze if there are urodynamic differences in patients with neurogenic detrusor overactivity (NDO) secondary to spinal cord injury (SCI) depending on whether the SCI is complete or incomplete according to the American Spinal Injury Association (ASIA) classification.

METHODS

A retrospective and comparative study was carried out, including 194 patients with suprasacral SCI and NDO. Maximum cystometric capacity (MCC), volume at first involuntary contraction (VIC), compliance, maximum pressure of the detrusor during filling cystometry (MaxDetP), detrusor leak point pressure (LeakDetP) and postvoid residual urine volume (PVR) were analysed. Means were compared with Student t test for independent samples, with statistical significance p < 0.05.

RESULTS

SCI was complete (ASIA A) in 51 patients (26.3%) and incomplete (ASIA B-E) in 143 (73.7%). The comparison of means showed significant differences regarding MCC (278.5 ± 102.6 mL in ASIA A vs. 321.6 ± 127.1 mL in ASIA B-E; p = 0. 018) and VIC (161 ± 85.1 and 210 ± 114.4 mL -respectively; p = 0.006). There were no differences regarding MaxDetP (58.8 ± 26.9 vs. 49.3 ± 35.6 cm H2O), LeakDetP (44.6 ± 25.3 vs. 48.3 ± 26.7 cm H2O), PVR (155.3 ± 94.2 vs. 118.5 ± 129.8) or compliance (29.9 ± 25.3 vs. 48.3 ± 26.7 cm H2O).

CONCLUSIONS

In our serie incomplete SCI (ASIA B-E) showed differences from complete ones (ASIA A) regarding MCC and VIC, but not regarding LeakDetP, MaxDetP, PVR or compliance.