Classification of and Treatment Principles for Bladder Dysfunction Caused by Spinal Cord Injury

Bladder capacity (ml)

Bladder pressure (KPa)

Urethral pressure (KPa)

Residual volume (ml)

Urine culture (+)

Urine return

Urinary tract infection

Renal damage

300 ± 100

7 ± 2

6 ± 1

40 ± 10

1 (16 %)

300 ± 100

7 ± 2

6 ± 1.5

50 ± 10

1 (20 %)

150 ± 100

9 ± 3

8 ± 1.5

100 ± 30

7 (55 %)

5 (38 %)

500 ± 200

4 ± 1

4 ± 1.5

200 ± 100

10 (83 %)

1 (8.3 %)

Bladder volume pressure curve: the results of Groups A and B are close to normal and there were very few reflected waves. The slope of Group C increased, and the curve shifted left. There were many reflected waves. Group D had very flat curve that shifted right, and there was no reflected wave.

Detrusor reflection: Groups A and B had hyperreflexia, Group C had obvious hyperreflexia and Group D had no hyperreflexia.

Bladder compliance: Groups A and B were close to normal. Group C had low compliance, while Group D had high compliance.

Electromyography of the detrusor and sphincter: The detrusor and sphincter harmonized with each other in Groups A and B while they were inharmonious in Group C. The detrusor and sphincter were unrelated with each other in Group D.

The test results showed that urodynamic performance varies according to the different site and degree of spinal cord injury. Different urodynamic performance leads to different bladder function and complications. In this regard, the urodynamic classification of the bladder is very important to the prevention and treatment of complications, as well as the improvement and recovery of bladder function.

3.4 Discussion

Clinical manifestation of the bladder after spinal cord injury is complicated, and there are many ways of classification. Turner-Warwick is a frequently used method that classifies patients’ bladder into detrusor hyperreflexia and detrusor areflexia.

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