Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury

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.