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Can we predict the recovery of bladder function in spinal cord injury patients – A retrospective study of 30 patients

Author: 
Dr. Arnab Sinha and Dr. Rashmi Sharma
Subject Area: 
Health Sciences
Abstract: 

Today mortality from SCI has declined dramatically partly owing to the improved management of urologic dysfunction associated with SCI. Neurogenic bladder dysfunction represents one of the most common and devastating sequelae of SCI.Urinary continence and volitional control of voiding influence a SCI patient’s potential for independence and the ability to function in the workplace. Early prediction of bladder function might optimize counselling and patient-tailored rehabilitative interventions. To investigate whether spinothalamic tract preservation and posterior column sparing are predictors of neurogenic recovery of bladder function after spinal cord injury, a retrospective study of case records of 30 patients were done. The results of the ASIA grade at presentation, initial perianal pinprick sensation (PPP) and position sense of the great toes (PGT) were analysed and then compared to the bladder function at 1 year after SCI. ASIA grading gives an idea of the chances of bladder recovery. Both perianal pinprick sensation and toe position sense also gives an idea for predicting return of bladder function. A patient without initial position sense of the great toes will likely not regain volitional voiding, whereas a patient without initial perianal pinprick sensation will definitely not regain volitional voiding.But these clinical tests, cannot predict detrusor hyperreflexia and sphincter dyssynergia. Therefore, urodynamic study remains an essential component of initial urologic evaluation after SCI.

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