Holschneider A M, Pöschl U, Lang R
Monatsschr Kinderheilkd (1902). 1979 Jun;127(6):392-6.
Clinical and cystometrical studies were performed in 48 patients with myelomeningocele. From the clinical point of view four of the patients were completely continent. Fiften patients showed a so called "social continence" with periods of continence lasting for more than two hours (40%). Cystomanometric evaluations, however, revealed that there was a complete continence only in one of the 48 patients. Twenty-one patients showed a spastic or reflex bladder (44%), twentysix (54%) an adynamic bladder. The so called "social continence" could be observed as well in spastic-as in adynamic bladders. The most important parameters to realize neurogenic disturbances of micturition is the dyssynergia of the contraction of the detrusor muscle and the relaxation of the external vesical sphincter. Considering this, Stark's classification of adynamic and spastic bladders according to amplitude of the contractions of the detrusor muscle is helpful only in combination with the cystometrical and myographical datas of the bladder outlet.
对48例脊髓脊膜膨出患者进行了临床和膀胱测压研究。从临床角度看，4例患者完全控尿。15例患者表现出所谓的“社交控尿”，控尿期持续超过两小时（40%）。然而，膀胱测压评估显示，48例患者中只有1例完全控尿。21例患者表现为痉挛性或反射性膀胱（44%），26例（54%）表现为无张力性膀胱。在痉挛性膀胱和无张力性膀胱中都可以观察到所谓的“社交控尿”。认识排尿神经源性障碍的最重要参数是逼尿肌收缩与膀胱外括约肌松弛的协同失调。考虑到这一点，斯塔克根据逼尿肌收缩幅度对无张力性和痉挛性膀胱的分类只有结合膀胱出口的膀胱测压和肌电图数据才有用。
