Penders L, de Leval J
J Urol (Paris). 1984;90(6):375-83.
The authors reviewed the simultaneous urethrocystometry (SUCM) of 96 hyperactive bladders subclassified into 4 groups (pure detrusor instability, mixed instability, suprasacral spinal lesion, and CNS lesion) and compared the frequency of various urethral parameters. The absence of urethral relaxation before or during the augmentation of the detrusor pressure is the most specific sign of suprasacral spinal lesions. It constitutes what we call passive or tonic dyssynergia. When, in the beginning of SUCM, the maximal closure pressure is greater than or equal to 30 cm H20, or when a sphincteric contraction is associated with, either before ("kick") or during (active or clonic dyssynergia) the detrusor contraction, this urethral non relaxation is pathognomonic of such a spinal lesion. A "kick" is also specific of hyperreflexia but is less constant. On the contrary, in this series and with this technic, an active dyssynergia has no etiological significance; it' only reflects the degree of the vesicosphincteric imbalance.
作者回顾了96例膀胱活动亢进患者的同步膀胱尿道测压（SUCM），这些患者被分为4组（单纯逼尿肌不稳定、混合性不稳定、骶上脊髓损伤和中枢神经系统损伤），并比较了各种尿道参数的出现频率。在逼尿肌压力增加之前或期间尿道无松弛是骶上脊髓损伤最具特异性的体征。它构成了我们所说的被动性或强直性协同失调。在同步膀胱尿道测压开始时，最大关闭压大于或等于30 cm H2O，或者在逼尿肌收缩之前（“踢动”）或期间（主动性或阵挛性协同失调）出现括约肌收缩时，这种尿道无松弛是此类脊髓损伤的特征性表现。“踢动”也是反射亢进的特异性表现，但不太常见。相反，在本研究系列及采用该技术的情况下，主动性协同失调没有病因学意义；它仅反映了膀胱括约肌失衡的程度。
