Urodynamic and rectomanometric findings in patients with spinal cord injury

Patients with spinal cord lesion suffer from complex disorders of bladder a nd anorectal function. We assessed the value of urodynamics and anorectal m anometry as prognostic and diagnostic tools in these patients and evaluated the usefulness of these techniques for the differentiation between complet e and incomplete spinal cord lesions. Thirty patients with suprasacral spin al cord injury (six women, 24 men: mean age, 31 years) underwent anorectal manometry and urodynamics within the first 40 days after injury. The findin gs were compared to the results of a clinical neurologic evaluation. Fiftee n patients were classified as complete lesions on their clinical signs, thr ee of these lesions were incomplete according to urodynamic testing and fiv e were incomplete according to visceral sensory testing by anorectal manome try. Despite significant differences in maximum bladder capacity (589 versu s 465 mL), maximum detrusor pressure (18 versus 31 cm H2O) was not signific antly different between patients with complete and patients with incomplete spinal cord injury. Anorectal manometry did not reveal any significant dif ferences in resting pressure, abdominal pressure, and maximal rectum volume between these groups. Urodynamics and anorectal manometry may be superior to neurologic assessment of completeness of spinal cord lesions. Urodynamic s and anorectal manometry were not helpful in the prediction of onset or se verity of detrusor hyperreflexia. Thus. we do not regard anorectal manometr y as a standard diagnostic tool in spinal cord injury patients. Neurourol. Urodynam. 20:95-103, 2001. (C) 2001 Wiley-Liss, Inc.