Urodynamic study of Bladder Behaviour in Traumatic Spinal Cord Injury Patients in Response to Rehabilitation

Objective To study the bladder behaviour in response to rehabilitation intervention in traumatic spinal cord injury (SCI) patients using urodynamic study (UDS) and to compare the nature of the bladder in a rehabilitated and nonrehabilitated neurogenic bladder of traumatic SCI. Study design Prospective follow-up study. Setting Rehabilitation ward of National Institute for the Orthopaedically Handicapped. Material and Method Thirty traumatic SCI patients mean age 31.4±7.9 years, 26 males and 4 females, admitted for rehabilitation were done UDS to see the bladder behaviour in response to rehabilitation intervention and compare the nature of bladder of the rehabilitated and that of the non-rehabilitated neurogenic bladder. Rehabilitation of the bladder was done at least for three months. The study lasted for 2 years with a minimum of one year follow-up. Result In upper motor neuron (UMN) neurogenic bladders there were significant changes in the max. cystometric capacity (p=0.018) after rehab intervention. The compliance, Pdet. at first desire to void and Pdet. at max. cystometric capacity of these patients were also found to have significant correlations (p=0.012, 0.010 and 0.014 respectively). But the volume at the first desire to void does not show must significant changes after rehab intervention (p=0.45). Significant reduction of amplitude and frequency was found in involuntary contractions (detrusor hyper-reflexia). In similar comparison of the lower motor neuron (LMN) neurogenic bladder significant changes after rehab intervention, could be found only in the max. cystometric capacity (p=0.018). Other variables like compliance, volume at first desire to void, Pdet. at first desire to void, and Pdet. at max. cystometric capacity were found to have no significant changes after rehab intervention (p=0.168, 0.194, 0.324, 0.302 respectively). Conclusion The change in the nature of the rehabilitated neurogenic bladder is different with the type of bladder.