Urinary dysfunction in patients with cervical spinal cord injury

Cervical spinal cord injury (CSCI) is characterized by severe motor and sensory impairments and pelvic organs dysfunction, among which urinary dysfunction (UD) has a special place. The pathogenesis of UD associated with impaired communication between spinal and pontine micturition centers. The article presents the experience of observation of 112 patients with CSCI in the medical center of the III rehabilitation phase. The duration of observation ranged from 3 to 7 years. All patients passed complex urological examination every 1-2 years. Despite of the same level of SCI, clinical picture of urination disorders was different. Neurogenic detrusor overactivity was found in 55 (49.2%) of patients; 46 (41.2%) patients had a detrusor-sphincter dyssynergia with different degrees of voiding dysfunction; 8 (7.1%) patients had voluntary micturition; 3 (2.7%) patients had decreased urinary bladder capacity. The examination included urodynamic study and radiological examination; 83 (74.1%) patients had a stable clinical picture of urination disorders in the first year after the injury. The aim of urological rehabilitation included reduction and prevention of high detrusor pressure, adequate emptying of the bladder by periodic clean intermittent catheterization, prevention and treatment of urinary tract infection. The main criterion for the effectiveness of urological rehabilitation was improvement of quality of life, which was observed in 83% cases. Thereby, patients with cervical spinal cord injury require regular urological rehabilitation, which includes not only correction of urinary dysfunction but also monitoring and prevention of urological complications.

neurogenic bladder, cervical spinal cord injury, detrusor sphincter dyssynergia, clean intermittent catheterization, pelvic organs dysfunction