The Role of Bladder Compliance Observed by the Videourodynamic Study in Spinal Cord Injured Patients

Ahn, Joo Hyeong; Suh, Jun Kyu; Lee, Tack

Abstract

PURPOSE: The purpose of the present study was to examine the changes in bladder compliance of a spinal cord injured population, and analyze the effects of several factors, related to the clinical and urodynamic findings, on bladder compliance.
MATERIALS AND METHODS
The charts, videourodynamic and upper tract radiographic studies of 114 patients with a spinal cord injury were retrospectively reviewed. The patients were categorized according to their bladder and urethral activities from the videourodynamic study, the interval since the time of the injury and the bladder emptying method, including intermittent catheterization (IC), self voiding and Foley catheterization. The association of bladder compliance with upper/lower tract complications was also identified in the population. A bladder compliance threshold values of 12.5ml/cm H2O was selected for the comparison between a normal and decreased compliance.
RESULTS
No significant differences in compliance were noted in relation to sex, age or level of injury. Of the 114 patients, 43 (37.4%), by definition, had a low bladder compliance. The patients whose interval since the time of injury was more than one year had a significantly higher incidence of low compliance than those of less than one year. Low compliance was more common in patients using an indwelling catheter than in those using the other methods. A low compliance was statistically associated with more deformity of the bladder shape (p<0.05) and upper tract complications (p<0.05).
CONCLUSIONS
In a spinal cord injured population, compliance may be one of the most important factors resulting in upper/lower urinary tract complications. With time, or due to the wrong treatment, there is a great possibility of a low compliance. Therefore, regular observation of the compliance, and other factors, using urodynamic studies, is warranted.