Video urodynamic findings in men with the central cord syndrome

Purpose: The central cord syndrome reportedly has a favorable prognosis and rehabilitation outcome. However, to our knowledge the status of the lower urinary tract in patients with the central cord syndrome is unclear, We rep ort on 22 men with the central cord syndrome who were evaluated by video ur odynamics, Materials and Methods: From 1986 to the present we identified 22 men with a mean age of 51 years who had the central cord syndrome and were included i n the Houston Veterans Affairs spinal cord registry. All patients underwent video urodynamic evaluation a mean of 34.5 months after injury. Results: Video urodynamic testing for vesicourethral dysfunction was normal in 3 patients, while it showed bladder outlet obstruction secondary to ben ign prostatic hyperplasia in 2, detrusor areflexia in 4, external detrusor- sphincter dyssynergia in 11, detrusor hyperreflexia with a synergistic exte rnal urethral sphincter in 1 and detrusor hypocontractility in 1. Urinary t ract infection recurred in 3 patients with external detrusor-sphincter dyss ynergia and urolithiasis developed in 2. Conclusions: Urodynamic testing revealed a high incidence of external detru sor-sphincter dyssynergia in men with the central cord syndrome. Due to the potential for upper tract deterioration all patients with the central cord syndrome should undergo baseline urodynamic studies. Those at high risk fo r upper tract deterioration with external detrusor-sphincter dyssynergia or a loss of compliance should be treated more aggressively with clean interm ittent catheterization and anticholinergic medication when possible.