Kj. Weld et al., Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury, UROLOGY, 56(4), 2000, pp. 565-568
Objectives. To investigate the significance of categorizing detrusor sphinc
ter dyssynergia (DSD) by type in patients with chronic spinal cord injury.
Methods. A retrospective review of the charts, video-urodynamic studies, an
d upper tract radiographic studies of 269 patients with post-traumatic, sup
rasacral spinal cord injuries was performed. The patients were categorized
according to the DSD type (intermittent or continuous), level and completen
ess of injury, intravesical pressure at leak, upper tract complications, an
d interval since injury.
Results. Of the 269 patients, 20 (7.4%), 216 (80.3%), and 33 (12.3%) had no
DSD, intermittent DSD, and continuous DSD, respectively. No significant as
sociation between the specific level of injury and the DSD type was found (
P = 0.71). The presence of DSD was associated with complete injuries, eleva
ted intravesical pressures, and upper tract complications (P <0.01); these
associations were more prominent with continuous DSD than with intermittent
DSD. The proportion of patients with no DSD, intermittent DSD, and continu
ous DSD was unchanged during the chronic follow-up period.
Conclusions. The clinical significance of DSD type is not crucial, since pa
tients with both intermittent and continuous DSD require urodynamic surveil
lance and expedient treatment to minimize urologic complications. However,
the presence of continuous DSD is one of several factors that may require e
arlier urodynamic follow-up. UROLOGY 56: 565-569, 2000. (C) 2000, Elsevier
Science Inc.