Urodynamic profile in acute transverse myelitis patients: Its correlation with neurological outcome

ABSTRACT Objective: The objective of this study was to observe urodynamic profile of acute transverse myelitis (ATM) patients and its correlation with neurological outcome. Patients and Methods: This prospective study was conducted in the neurorehabilitation unit of a tertiary university research hospital from July 2012 to June 2014. Forty-three patients (19 men) with ATM with bladder dysfunction, admitted in the rehabilitation unit, were included in this study. Urodynamic study (UDS) was performed in all the patients. Their neurological status was assessed using ASIA impairment scale and functional status was assessed using spinal cord independence measure. Bladder management was based on UDS findings. Results: In total, 17 patients had tetraplegia and 26 had paraplegia. Thirty-six patients (83.7%) had complaints of increased frequency and urgency of urine with 26 patients reported at least one episode of urge incontinence. Seven patients reported obstructive urinary complaints in the form of straining to void with 13 patients reported both urgency and straining to void and 3 also had stress incontinence. Thirty-seven (86.1%) patients had neurogenic overactive detrusor with or without sphincter dyssynergia and five patients had acontractile detrusor on UDS. No definitive pattern was observed between neurological status and bladder characteristics. All patients showed significant neurological and functional recovery with inpatient rehabilitation (P< 0.05 and P< 0.001, respectively). Conclusions: The problem of neurogenic bladder dysfunction is integral to ATM. Bladder management in these patients should be based on UDS findings. Bladder characteristics have no definitive pattern consistent with the neurological status.

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Residual bladder dysfunction 2 to 10 years after acute transverse myelitis

Journal of Paediatrics and Child Health ◽

10.1046/j.1440-1754.1999.355411.x ◽

1999 ◽

Vol 35 (5) ◽

pp. 476-478 ◽

Cited By ~ 11

Author(s):

W Cheng ◽

RW Chiu ◽

PKH Tam

Keyword(s):

Bladder Dysfunction ◽

Transverse Myelitis ◽

Acute Transverse Myelitis

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Poster 173 Continuous Quality Improvement (CQI): A Two Phase Study on Bladder Management for Patients Admitted to an Inpatient Rehabilitation Unit

PM&R ◽

10.1016/j.pmrj.2014.08.567 ◽

2014 ◽

Vol 6 (9) ◽

pp. S245-S246

Author(s):

Jason Chen ◽

Jess J. Arcure ◽

Avram Bram-Mostyn ◽

Meilani H. Mapa

Keyword(s):

Quality Improvement ◽

Continuous Quality Improvement ◽

Inpatient Rehabilitation ◽

Rehabilitation Unit ◽

Two Phase ◽

Continuous Quality ◽

Phase Study ◽

Bladder Management

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Clinical Approach to Pediatric Transverse Myelitis, Neuromyelitis Optica Spectrum Disorder and Acute Flaccid Myelitis

Children ◽

10.3390/children6050070 ◽

2019 ◽

Vol 6 (5) ◽

pp. 70 ◽

Cited By ~ 1

Author(s):

Cynthia Wang ◽

Benjamin Greenberg

Keyword(s):

Clinical Presentation ◽

Bladder Dysfunction ◽

Transverse Myelitis ◽

Bowel Dysfunction ◽

Spectrum Disorder ◽

Clinical Approach ◽

Acute Flaccid Myelitis ◽

Acute Transverse Myelitis ◽

Immune Mediated

Pediatric transverse myelitis (TM) is an acquired, immune-mediated disorder that leads to injury of the spinal cord and often manifests as weakness, numbness, bowel dysfunction, and/or bladder dysfunction. Multiple etiologies for myelitis can result in a similar clinical presentation, including idiopathic transverse myelitis (TM), multiple sclerosis (MS), neuromyeltis optica spectrum disorder (NMOSD) associated with anti-aquaporin 4 antibodies, MOG antibody-associated disease, and acute flaccid myelitis (AFM). Diagnosis relies on clinical recognition of the syndrome and confirming inflammation through imaging and/or laboratory studies. Acute treatment is targeted at decreasing immune-mediated injury, and chronic preventative therapy may be indicated if TM is determined to be a manifestation of a relapsing disorder (i.e., NMOSD). Timely recognition and treatment of acute transverse myelitis is essential, as it can be associated with significant morbidity and long-term disability.

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Bladder dysfunction in acute transverse myelitis: magnetic resonance imaging and neurophysiological and urodynamic correlations

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.73.2.154 ◽

2002 ◽

Vol 73 (2) ◽

pp. 154-159 ◽

Cited By ~ 37

Author(s):

J Kalita

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Bladder Dysfunction ◽

Transverse Myelitis ◽

Resonance Imaging ◽

Acute Transverse Myelitis

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Persistent Motor Deficits Predict Long-Term Bladder Dysfunction in Children Following Acute Transverse Myelitis

The Journal of Urology ◽

10.1016/j.juro.2008.03.092 ◽

2008 ◽

Vol 180 (4S) ◽

pp. 1774-1777 ◽

Cited By ~ 8

Author(s):

Daniel G. DaJusta ◽

Matthew S. Wosnitzer ◽

Joseph G. Barone

Keyword(s):

Bladder Dysfunction ◽

Transverse Myelitis ◽

Motor Deficits ◽

Acute Transverse Myelitis

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Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.145194 ◽

2014 ◽

Vol 05 (S 01) ◽

pp. S013-S016 ◽

Cited By ~ 1

Author(s):

Nitin Menon ◽

Anupam Gupta ◽

Arun B. Taly ◽

Meeka Khanna ◽

Sushruth Nagesh Kumar

Keyword(s):

Spinal Cord ◽

Length Of Stay ◽

Neurogenic Bladder ◽

Functional Recovery ◽

Neurological Recovery ◽

Urodynamic Study ◽

Rehabilitation Unit ◽

Overactive Detrusor ◽

Detrusor Sphincter Dyssynergia ◽

Acontractile Detrusor

ABSTRACT Objectives: To observe neurogenic bladder pattern in patients with myelopathy by performing urodynamic study (UDS) and to observe whether it has any correlation with functional and neurological recovery. Patients and Methods: This prospective study was conducted with 90 patients with myelopathy, both traumatic and non-traumatic (males = 65) in a university tertiary research hospital in India between January 2011 and December 2013. Mean age was 33.5 ± 13.2 years (range 15-65 years), mean duration of injury was 82.63 ± 88.3 days (range 14-365 days) and mean length of stay (LOS) in the rehabilitation unit 42.5 ± 23.3 days (range 14-130 days). The urodynamic study was performed in all the patients to assess the neurogenic bladder pattern. Management was based on the UDS findings. Functional recovery was assessed using Barthel index (BI) scores and spinal cord independence measures (SCIM) scores. Neurological recovery was assessed using ASIA impairment scale (AIS). We tried to correlate neurogenic bladder patterns with recovery. Results: Fifty patients (55.6%) had overactive detrusor with 25 each had detrusor sphincter dyssynergia (DSD) and synergic sphincter. Thirty-eight patients had hypoactive/acontractile detrusor and two had normal studies. No significant correlation observed between neurogenic bladder pattern and change in BI scores (P = 0.696), SCIM scores (P = 0.135) or change in ASIA status (P = 0.841) in the study. Conclusions: More than half of the patients with myelopathies had overactive detrusor with or without dyssynergic sphincter according to the urodynamic study. Neurogenic bladder patterns had no significant correlation with functional and neurological recovery in these patients.

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