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      Association between detrusor muscle function and level of the spinal cord injury

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          Abstract

          Introduction

          Traumatic spinal cord injury (TSCI) is among the most severe disabilities with an estimation of 2.5 million people affected worldwide. The purpose of this study was to investigate the association between detrusor muscle function and the level of the spinal cord injury.

          Material and methods

          All patients with TSCI who underwent urodynamic evaluation at the Brain and Spinal Injury Research Center (BASIR) of Imam Khomeini hospital complex from March 2014 to March 2016 were retrospectively entered in this cross-sectional study. The patients were divided into three groups of suprasacral (C1-T12), sacral (L1-S5) and combined (both suprasacral and sacral) lesions.

          Results

          Medical records of 117 patients with spinal cord injury were reviewed. The mean age of the patients was 35.64 (±12.01) years. 86 patients (73.5%) were male and 31 female (26.5%). While 66 (56.4%), 28 (23.9%) and 19 (16.2%) patients had suprasacral, sacral, and combined suprasacral and sacral lesions, respectively. The relationship between the level of injury and emptying disorder (P = 0.50), storage disease (P = 0.20), first desire to void (P = 0.82), hypocompliance (P = 0.95), voided urine volume (P = 0.38) and residual urine volume (P = 0.76) were not significant. We found a significant association between the level of injury and the type of detrusor function (P = 0.019).

          Conclusions

          Our study showed an association between detrusor muscle function and level of the spinal cord injury. However, there was no exact relationship between the level and the completeness of the spinal cord injury with the urodynamic characteristics.

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          Most cited references16

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          The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society.

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            Incidence of traumatic spinal cord injury worldwide: a systematic review.

            Traumatic spinal cord injuries (TSCI) are among the most devastating conditions in developed and developing countries, which can be prevented. The situation of TSCI around the world is not well understood which complicates the preventive policy decision making in fight against TSCI. This study was aimed to gather the available information about incidence of TSCI around the world.
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              Neurogenic bladder in spinal cord injury patients

              Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.
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                Author and article information

                Journal
                Cent European J Urol
                Cent European J Urol
                CEJU
                Central European Journal of Urology
                Polish Urological Association
                2080-4806
                2080-4873
                09 January 2017
                2018
                : 71
                : 1
                : 92-97
                Affiliations
                [1 ]Sina Trauma and Surgey Research Center, Tehran University of Medical Sciences, Tehran, Iran
                [2 ]Urology division, Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
                [3 ]Department of Orthopedic Surgery and Neurosurgery, The Rothman Institute, Thomas Jefferson University, PA, USA
                [4 ]Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Corresponding author Vafa Rahimi-Movaghar Tehran University of Medical Sciences Sina Trauma and Surgey Research Center Hasan-Abad Square Imam Khomeini Ave 11365-3876 Tehran, Iran. v_rahimi@ 123456tums.ac.ir
                Article
                1263
                10.5173/ceju.2017.1263
                5926627
                d2f48cde-86b2-4607-b3a3-48c082d34544
                Copyright by Polish Urological Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 14 February 2017
                : 07 July 2017
                : 26 December 2017
                Categories
                Original Paper

                spinal cord injury,urodynamic,urinary bladder,detrusor muscle

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