Comparison between Conventional Cystometry and Diuretics Stimulated Filling Cystometry in Neurogenic Bladder after Spinal Cord Injury

Ko, Hyun Yoon; Park, Ho Joon; Kim, Hoon; Shin, Young Beom; Lee, Jong Eon

Abstract

OBJECTIVE
To determine whether cystometry performed by bladder filling stimulation using furosemide (DCMG) reveals different findings compared to conventional cystometry (CCMG) in the neurogenic bladder. METHOD: The maximum intravesical pressure (MPves) and compliance of the bladder in CCMG and DCMG were compared in 24 patients with neurogenic bladder after spinal cord injury. The MPves was estimated by urethral leak pressure or intravesical pressure at 600 ml filling. Compliance was calculated from the cystometric bladder capacity and the MPves. For CCMG, the bladder was filled with 32oC normal saline via 10 F urethral catheter at 50 ml/min until the patient leaked or filled 600 ml. Three hours later, 20 mg of furosemide was injected intravenously after intravenous infusion of 300 ml normal saline for DCMG. Ultrasound measuring of filled urine volume was made at least every 5 minutes until defined MPves.
RESULTS
Significant differences were found between DCMG and CCMG in hyperreflexic neurogenic bladders with respect to: decrease in MPves (p<0.05) and increase in compliance (p<0.05) in DCMG. There was no significant differences in MPves and compliance in hyporeflexic or areflexic neurogenic bladders between the two techniques (p>0.05).
CONCLUSION
We have found DCMG provides a more effective and near physiological diagnostic method of detrusor characteristics than CCMG in evaluating both genuine MPves and compliance in patients with hyperreflexic neurogenic bladder.