THE VALUE OF SYMPATHETIC SKIN-RESPONSE RECORDINGS IN THE ASSESSMENT OF THE VESICOURETHRAL AUTONOMIC NERVOUS DYSFUNCTION IN SPINAL-CORD INJURED PATIENTS

Purpose: We assessed the degree of sparing of the descending sympathet ic spinal tract and correlated these findings with bladder neck functi on in spinal cord injured patients. Materials and Methods: Sympathetic skin responses of the right hand and foot were recorded and compared to the urodynamic findings in 27 spinal cord injured patients. Results : All tetraplegic and paraplegic patients with a lesion above the T6 l evel who presented with bladder neck dyssynergia associated with auton omic hyperreflexia had abnormal sympathetic skin responses in the righ t hand and foot. All patients with a lesion below the T6 and above the T12 levels with an abnormal sympathetic skin response in the right fo ot also had bladder neck dyssynergia. Conclusions: Evidence is present ed that the integrity of the descending sympathetic spinal tract is ne cessary for a synergic function of the vesicourethral complex and that sympathetic skin responses are of value in the diagnosis of bladder n eck dyssynergia. For lesions below the T12 level other investigative m ethods to exclude bladder neck dyssynergia are necessary.