The usefulness of rapid injection cystometry in the patients with acutely overdistended bladder / 대한비뇨기과학회지

It is known that if the detrusor integrity is maintained, a single coordinated sustained contractile relaxation curve can be observed on rapid injection cystometry in the paralytic period after overdistention, but there is no study on its clinical significance. This study is to know the diagnostic usefulness of such relaxation curve in assessing the possibility of the voiding function recovery in the paralytic period after overdistention. We performed rapid injection cystometrys in 12 patients who had no contraction and sense on medium injection cystometry until 450ml infusion after non-neurogenic acute urinary retention by various causes, and compared the duration for recovery and the presence or absence of a single coordinated sustained contractile relaxation curve, the bladder volume at the first time of such a relaxation curve and the maximum pressure of contraction curve. The results were as follows; 1. All of 3 patients without a single coordinated sustained contractile relaxation curve did not recover their voiding function until three months after overdistention. 2. All of 9 patients with single coordinated sustained contractile relaxation curve recovered their voiding function within four weeks. 3. In 9 patients who recovered their voiding function, the smaller the bladder volume at the first such relaxation curve, the shorter the duration for recovery(r=0.69767. p=0.036), but there is no relationship between the maximum pressure of contraction curve and the duration for recovery(r=-0.10192, p=0.794). In conclusion, rapid injection cystometry is a useful clinical test to check the possibility of voidingfunction recovery within a few weeks in the paralytic period after acute overdistention.

A case of nonneurogenic neurogenic bladder (Hinman syndrome) / 대한비뇨기과학회지

Nonneurogenic neurogenic bladder is a condition in which the patient is with day and night wetting, infected urine, residual urine, reflux and upper tract damage without neurologic lesion or anatomical obstruction. Recently it is known that some patients with pediatric unstable bladder may contract their external sphincter to inhibit the detrusor contraction and pathological persistence of this "hold on" habit after they master a normal mature pattern of cortical control over the detrusor may result in nonneurogenic neurogenic bladder. The condition is reversible by bladder training with various methods. We report a case of nonneurogenic neurogenic bladder who is treated by self CIC after ileocecocystoplasty because bladder retraining has been failed due to high fever and severe frequency.