Clinical Significance of Urodynamic Test in Korean Spinal Cord Injured Patients.

초록

Aim : It is difficult to predict bladder and sphincter behavior based on clinical somatic neurological deficits. Most experts agree that urodynamic testing is the best method to detect and categorize the various neuro-urological dysfunctional states. Our purpose is not only to categorize Korean Spinal cord injured(SCI) patients based on urodynamic findings, but also to identify which urodynamic parameters are predictive of the development of renal complications. Patients and methods : We reviewed retrospectively 100 male Korean traumatic SCI patients(mean age:47.3 years, mean follow-up period : 17.9 years), who took complete urodynamic tests and periodic follow-up tests for upper tract status. We classified our patients according to spinal injured levels and urodynamic findings to ascertain the relationship between bladder functional patterns and neurological deficits. Our patients were grouped into detrusor are flexia(group 1)and detrusor hyper reflexia group(group2) for recognizing which parameters were related to upper tract deterioration. we used Students t-test for statistical analysis. Results : The bladder and sphincter behavior of 100 SCI patients at either the cervical, thoracic, lumbar or sacral level are depicted in Table. Fifty five patients had low complicant bladders. Bladders were low compliant in 55.7 percent of them with suprasacral lesions and 52.4% of them with sacral/infrasacral lesions. Hydronephrosis or reflux was present in 36.4% of them with low compliant bladders and 15.6% of them with normal compliant bladders. Maximum detrusor pressure during urine storage in group 1 with abnormal upper tract(mean : 89.4cmH2O). was not significantly higher in those with normal kidneys(mean 77.8cmH2O). Maximum detrusor contraction pressure during voiding in group 2 with abnormal upper tract(mean:99.9camH2O) was not significantly higher in those with normal upper tracts(mean:97.0caH2O). Conclusions : We confirmed that results of urodynamic tests were dif