Correlation between clinical neurological data and urodynamic function in spinal cord injured patients

Abstract

In 92 patients with spinal cord lesion, out of spinal shock, the data from a clinical neurological examination of the lumbosacral area are compared with the data from a full urodynamic investigation, including evaluation of sensation in the lower urinary tract. A significant correlation can be found between different levels of spinal cord lesion, the function of bladder neck and sphincter and the anal bulbocavernosus reflexes. Higher lesions correspond more with a reflexic lower urinary tract and somatic motor activity, lower lesions more with areflexia. With a lesion between thoracic 10 and lumbar 2 as many reflexic as areflexic lower urinary tract dysfunctions were found. The presence or absence of perineal sensation of light touch corresponded significantly with the presence or absence of sensation in the lower urinary tract. Detrusor and striated sphincter reflexia/areflexia corresponded significantly with the presence/absence of bulbocavernosus and anal reflexes. Clinical neurological examination gives useful information which acceptably corresponds with the LUT function. However to decide on a detailed individual diagnosis, clinical examination is in our opinion insufficient. Urodynamic tests are needed for a profound evaluation of the function of different parts of the lower urinary tract and their interaction.