Buczyński A Z
Paraplegia. 1984 Jun;22(3):168-72. doi: 10.1038/sc.1984.30.
One of the most frequent difficulties in the rehabilitation of the hyperreflexic bladder in patients with spinal cord injuries is vesico-sphincter-dyssynergia. Comprehensive urodynamic investigations of bladder pressure, abdominal pressure, urethral sphincter electromyography, cystometry and urethral flow were performed. In patients with vesico-sphincter-dyssynergia two methods of treatment were applied: conservative, by alpha-blocking agents, and surgical by incision of the urethral sphincter or bladder neck. In 80 per cent conservative measures were successful in early cases, whereas this figure fell to 50 per cent when undertaken at a later stage. Ten per cent required surgical measures, usually incision of the external urethral sphincter. Sometimes in difficult cases monitoring micturition cysto-urethrography was performed.
脊髓损伤患者高反射性膀胱康复过程中最常见的困难之一是膀胱-括约肌协同失调。对膀胱压力、腹压、尿道括约肌肌电图、膀胱测压和尿流进行了全面的尿动力学检查。对于膀胱-括约肌协同失调的患者，采用了两种治疗方法：保守治疗，使用α阻滞剂；手术治疗，切开尿道括约肌或膀胱颈。在早期病例中，80%的保守治疗措施取得了成功，而在后期进行时，这一数字降至50%。10%的患者需要手术治疗，通常是切开尿道外括约肌。有时在困难病例中会进行排尿期膀胱尿道造影监测。
