Urodynamic characteristics and clinical interventions of neurogenic bladder following cerebrovascular accident / 第二军医大学学报

ABSTRACT

Objective To explore the urodynamic characteristics of neurogenic bladder caused by cerebrovascular accident and to evaluate its clinical intervention efficacy. Methods From March 2007 to July 2011, 40 patients with cerebrovascular accident-associated neurogenic bladder underwent a complete urodynamic study with electromyography. Their clinical data were analyzed retrospectively and the urine dynamics characteristics were summarized. Clinical interventions were given to the patients based on the urine dynamics characteristics and the clinical efficacies were observed. Results Twenty-three patients (57. 5%) had detrusor overactivity, 5 (12. 5%) had acontractile detrusor, 36 (90%) had security bladder, 2 (5%) had upper urinary tract dilation, and no patients had detrusor-externalsphincter dyssynergia. After clinical interventions based on urodynamic characteristics, water disappeared in 1 patient with upper urinary tract dilation and reduced in the other. The quality of life (QOL) score was 3.4±1.0 at 2 weeks after clinical interentions, which was significantly lower than that before intervention (4.4±0.6, P<0.01). QOL score was 2.9±0.8 at 3 months after interventions, which was significantly lower than those before and at 2 weeks after interventions (all P<0. 01). Conclusion Detrusor overactivity is the main urodynamic characteristic of cerebrovascular accident-associated neurogenic bladder, and detrusor-external sphincter dyssynergia, reflux and upper urinary tract dilation are rarely seen. Clinical interventions based on urodynamic characteristics can protect renal function and improve the QOL of the patients.