SYNCHRONOUS CYSTOSCOPY AND CYSTOMETRY IN THE MANAGEMENT OF NEUROGENICBLADDER DYSFUNCTION

The physical difficulties associated with cystoscopy and cystometry in the spinal cord injury patient led to a clinical trial of synchronous cystoscopy and cystometry in these individuals. Following a disappoin ting experience with external transducer methodology, a recently avail able fiberoptic microtransducer system was used and an effective syste m was developed. A total of 20 individuals with spinal cord injury und erwent a standard water cystometrogram on an examination table followe d by synchronous flexible cystoscopy and cystometry using a 5F fiberop tic microtransducer while seated in a chair. The results showed both p ressure tracings to be clinically identical. Uninhibited contraction s pikes, compliance curves and leak point pressures were essentially the same by both methods and artifact was not a problem. Given the speed, ease and reproducibility of this method, the difficulties with patien t transfer for these studies have been virtually eliminated. Two ureth ral instrumentations have been replaced by 1. Examination room time wa s decreased from 60 to approximately 10 to 15 minutes with half of the required personnel. Perhaps more importantly, these occasionally prob lematic individuals clearly prefer this streamlined approach and patie nt compliance with followup has improved.