Influence of bladder lithiasis on lower urinary tract dynamics in patients with spinal cord injury.

STUDY DESIGN

A prospective and a case-matched control study.

OBJECTIVES

To study the lower urinary tract dysfunction associated with bladder lithiasis in patients with spinal cord injury (SCI).

SETTING

Toledo (Spain).

METHODS

We have carried out a urodynamic study in 30 patients with SCI with lithiasis in their bladder before and 3 months after bladder endoscopic lithotripsy. This second study was compared with the urodynamic findings of a different group of 30 patients with SCI, without a history of bladder lithiasis, paired with cases by gender and date of urodynamic study.

RESULTS

We have found that the prevalence of neurogenic detrusor overactivity (NDO) was significantly different after bladder lithotripsy, although the cystomanometric capacity was significantly increased. A group of patients with lithiasis showed a maximum flow rate, a voiding maximum detrusor pressure and the detrusor contractility parameter Wmax lower than that in controls. On the other hand, a voiding abdominal straining was found to be significantly greater than that in controls.

CONCLUSIONS

Bladder lithiasis affects the presence of NDO in patients with SCI. Patients with SCI who develop bladder lithiasis present a lower detrusor contractility power compared with those who do not.