Ann Rehabil Med.  2014 Jun;38(3):353-359. 10.5535/arm.2014.38.3.353.

Clinical Significance of Urodynamic Study Parameters in Maintenance of Renal Function in Spinal Cord Injury Patients

• Shin JC
• Lee Y
• Yang H
• Kim DH

• KMID: 2165753
• DOI: http://doi.org/10.5535/arm.2014.38.3.353

Abstract

OBJECTIVE
To analyze association between urodynamic study (UDS) parameters and renal function in spinal cord injured (SCI) patients with neurogenic detrusor overactivity.
METHODS
Patients with a suprasacral SCI, who underwent UDS and radioisotope renogram at least twice between January 1, 2006 and January 31, 2013, were included. UDS (cystometric capacity, reflex volume, compliance, and maximal detrusor pressure) and radioisotope renogram (total effective renal plasma flow [ERPF] of both kidneys) data were collected. The following were conducted to reanalyze any association between reflex volume and ERPF: initial and follow-up results of consecutive evaluations were compared; a mixed-model regression analysis to account for clustered data was conducted to evaluate the association between UDS parameters and ERPF; and finally, a mixed-model analysis type 3 test with data pairs, of which the first evaluation showed involuntary detrusor contraction.
RESULTS
A total of 150 patients underwent 390 evaluations which were arranged into 240 pairs of consecutive evaluations, of which 171 had first evaluations with observed involuntary detrusor contraction. The following results were obtained: cystometric capacity was significantly larger and maximal detrusor pressure was significantly lower on follow-up; on univariate analysis, reflex volume and maximal detrusor pressure were significant, and multivariate analysis using these two parameters showed that maximal detrusor pressure is significantly associated with total ERPF; and no significant differences were observed.
CONCLUSION
Maximal detrusor pressure should be closely monitored in the urologic management of neurogenic detrusor overactivity in SCI patients. The results also may serve as a reference for regular UDS follow-up.

Keyword

Spinal cord injuries; Neurogenic urinary bladder; Urodynamics; Renal plasma flow

MeSH Terms

Compliance
Follow-Up Studies
Humans
Multivariate Analysis
Reflex
Renal Plasma Flow
Renal Plasma Flow, Effective
Spinal Cord
Spinal Cord Injuries*
Urinary Bladder, Neurogenic
Urodynamics*

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