Recently the conception of Neuropathic bladder is being changed with the aid of the modern medico- engineering development and the advanced neurological knowledge. In this observation, we tried to investigate and prove the bladder detrusor and urethral sphincteric function in our suspected neuropathic bladder and its interrelationship on voiding. From Jan. 1980 to April 1981, cystometric-electromyographic (C.M.G.) investigation was performed in 44 cases with voiding difficulty without obstruction in lower urinary tract and suspected neuropathic bladder.
The following results were obtained.
1. Cystosphincteric dyssynergia was noted in 12 cases (67%) of detrusor hyperreflexic 18 cases and in 10 cases (57%) of detrusor hyporeflexic 14 cases. Even though they have voiding difficulty or suspected neuropathic 14 cases. Even though they have voiding difficulty or suspected neuropathic bladder, normal C.M.G. findings were noted in
27%, but cystosphincteric dyssynergia in 33%.
2. In cervical vertebra injury, all of 12 cases were detrusor hyperreflexia, when cystosphincteric dyssynergia has noted in 18 cases (67%) and in thoracic vertebra injury 14 cases, detrusor hyperreflexia was noted in 2 cases (14%) and detrusor hyporeflexia in 8 cases (57%), and also cystosphincteric dyssynergia was noted in 6 cases (43%).
3. In sacral lesion 8 cases, detrusor hyperreflexia and detrusor hyporeflexia were noted in 2 cases respectively, and cystosphincteric dyssynergia (75%) was noted higher than that of cervical or thoracic cases.
4. The cases of less than 2 years in duration after vertebral injury or disease have cystosphincteric dyssynergia in 27%, but the cases of more than 2 years have cystosphincteric dyssynergia in 82%.
|