Influence of bladder lithiasis on lower urinary tract dynamics in patients with spinal cord injury

• Published in: Spinal cord Vol. 55; no. 8; pp. 765 - 768
• Main Authors: Vírseda-Chamorro, M, Salinas-Casado, J, Barroso-Manso, Á, Gutiérrez-Martín, P, Fuertes, M E
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-08-2017; Nature Publishing Group
• Subjects: 692/308/409; 692/499; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Bladder; Case-Control Studies; Contractility; Endoscopy; Female; Flow velocity; Human Physiology; Humans; Lithiasis; Lithotripsy; Lower Urinary Tract Symptoms - etiology; Lower Urinary Tract Symptoms - physiopathology; Male; Neurochemistry; Neuropsychology; Neurosciences; original-article; Patients; Prospective Studies; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - physiopathology; Treatment Outcome; Urinary bladder; Urinary Bladder - diagnostic imaging; Urinary Bladder - physiopathology; Urinary Bladder - surgery; Urinary tract; Urodynamics - physiology; Urogenital system; Urolithiasis - complications; Urolithiasis - diagnostic imaging; Urolithiasis - physiopathology; Urolithiasis - surgery
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2017.46

Study design:
A prospective and a case-matched control study.
Objectives:
To study the lower urinary tract dysfunction associated with bladder lithiasis in patients with spinal cord injury (SCI).
Setting:
Toledo (Spain).
Methods:
We have carried out a urodynamic study in 30 patients with SCI with lithiasis in their bladder before and 3 months after bladder endoscopic lithotripsy. This second study was compared with the urodynamic findings of a different group of 30 patients with SCI, without a history of bladder lithiasis, paired with cases by gender and date of urodynamic study.
Results:
We have found that the prevalence of neurogenic detrusor overactivity (NDO) was significantly different after bladder lithotripsy, although the cystomanometric capacity was significantly increased. A group of patients with lithiasis showed a maximum flow rate, a voiding maximum detrusor pressure and the detrusor contractility parameter Wmax lower than that in controls. On the other hand, a voiding abdominal straining was found to be significantly greater than that in controls.
Conclusions:
Bladder lithiasis affects the presence of NDO in patients with SCI. Patients with SCI who develop bladder lithiasis present a lower detrusor contractility power compared with those who do not.