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Traumatic Lesions

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Neuro-Urology

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Abstract

Traumatic lesions including head trauma, traumatic spinal cord injury and iatrogenic peripheral nerve injury can cause damage to this extensive network of innervations of the bladder. This will result in bladder and/or sphincter dysfunction like detrusor overactivity with or without detrusor sphincter dyssynergia and detrusor hypocontractility depending on the level and extent of injury. After the spinal shock phase is resolved, patients should be assessed by urodynamics.

Comorbidity is an important factor in these patients. Although mortality decreased and urologic and medical management improved, morbidity and patient well-being are still important issues in spinal cord injury patient management, including vesicoureteral reflux, urinary tract infections, urolithiasis and urinary incontinence. Autonomic dysreflexia is a potential life-threatening complication, which can occur during urological procedures.

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References

  1. Fowler CJ, Griffiths D, De Groat WC. The neural control of micturition. Nat Rev Neurosci. 2008;9(6):453–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Sekhon LHS, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. 2001;26:S2–S12.

    Article  CAS  PubMed  Google Scholar 

  3. Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord. 2006;44(9):523.

    Article  CAS  PubMed  Google Scholar 

  4. Geisler WO, Jousse AT, Wynne-Jones M, Breithaupt D. Survival in traumatic spinal cord injury. Paraplegia. 1983;21:364–73.

    PubMed  CAS  Google Scholar 

  5. McColl MA, Walker J, Stirling P, Wilkins R, Corey P. Expectations of life and health among spinal cord injured adults. Spinal Cord. 1997;35:818–28.

    Article  CAS  PubMed  Google Scholar 

  6. Van den Berg MEL, Castellote JM, De Pedro-Cuesta J, Mahillo-Fernandez I. Survival after spinal cord injury: a systematic review. J Neurotrauma. 2010;27:1517–28.

    Article  PubMed  Google Scholar 

  7. Soden RJ, Walsh J, Middleton JW, et al. Causes of death after spinal cord injury. Spinal Cord. 2000;38(10):604–10.

    Article  CAS  PubMed  Google Scholar 

  8. Ku JH, Choi WJ, Lee KY, Jung TY, Lee JK, Park WH, Shim HB. Complications of the upper urinary tract in patients with spinal cord injury: a long-term follow-up study. Urol Res. 2005;33:435–9.

    Article  PubMed  Google Scholar 

  9. Selzman AA, Hampel N. Urologic complications of spinal cord injury. Urol Clin North Am. 1993;20(3):453–64.

    PubMed  CAS  Google Scholar 

  10. Van Kerrebroeck PE, Koldewijn EL, Scherpenhuizen S, Debruyne FM. The morbidity due to lower urinary tract function in spinal cord injury patients. Paraplegia. 1993;31(5):320–9.

    PubMed  Google Scholar 

  11. Ismail S, Karsenty G, Chartier-Kastler E, Cussenot O, Compérat E, Rouprêt M, Phé V. Prevalence, management, and prognosis of bladder cancer in patients with neurogenic bladder: a systematic review. Neurourol Urodyn. 2018;37:1386–95.

    Article  PubMed  Google Scholar 

  12. Gajewski JB, Schurch B, Hamid R, Averbeck M, Sakakibara R, Agrò EF, Dickinson T, Payne CK, Drake M, Haylen B. An international continence society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD). Neurourol Urodyn. 2018;37:1152–61.

    Article  PubMed  Google Scholar 

  13. Karlsson AK. Autonomic dysreflexia. Spinal Cord. 1999;37:383–91.

    Article  CAS  PubMed  Google Scholar 

  14. Huang Y, Bih L, Chen G, Lin C, Chen S, Chen W. Autonomic dysreflexia during urodynamic examinations in patients with suprasacral spinal cord injury. Arch Phys Med Rehabil. 2011;92:1450–4.

    Article  PubMed  Google Scholar 

  15. Khastgir J, Drake MJ, Abrams P. Recognition and effective management of autonomic dysreflexia in spinal cord injuries. Expert Opin Pharmacother. 2007 May;8(7):945–56.

    Article  PubMed  Google Scholar 

  16. Liu N, Zhou M, Biering-Sørensen F, Krassioukov AV. Iatrogenic urological triggers of autonomic dysreflexia: a systematic review. Spinal Cord. 2015;53:500–9.

    Article  CAS  PubMed  Google Scholar 

  17. Silver J. Early autonomic dysreflexia. Spinal Cord. 2000;38:229–33.

    Article  CAS  PubMed  Google Scholar 

  18. Sayilir S, Ersöz M, Yalҫin S. Comparison of urodynamic findings in patients with upper and lower cervical spinal cord injury. Spinal Cord. 2013;51:780–3.

    Article  CAS  PubMed  Google Scholar 

  19. Giannantoni A, Di Stasi SM, Scivoletto G, Mollo A, Silecchia A, Fuoco U, Vespasiani G. Autonomic dysreflexia during urodynamics. Spinal Cord. 1998;36:756–60.

    Article  CAS  PubMed  Google Scholar 

  20. Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, Johansen M, Jones L, Krassioukov A, Mulcahey MJ, Schmidt-Read M, Waring W. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med. 2011;34(6):535–46.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Schuld C, Franz S, Van Hedel HJ, Moosburger J, Maier D, Abel R, van de Meent H, Curt A, Weidner N, EMSCI Study Group, Rupp R. International standards for neurological classification of spinal cord injury: classification skills of clinicians versus computational algorithms. Spinal Cord. 2015;53:324–31.

    Article  CAS  PubMed  Google Scholar 

  22. Spiess MR, Müller RM, Rupp R, Schuld C, EM-SCI Study Group, Van Hedel HJ. Conversion in ASIA Impairment Scale during the first year after traumatic spinal cord injury. J Neurotrauma. 2009;26:2027–36.

    Article  PubMed  Google Scholar 

  23. Ditunno JF, Little JW, Tessler A, Burns AS. Spinal shock revisited: a four-phase model. Spinal Cord. 2004;42:383–95.

    Article  CAS  PubMed  Google Scholar 

  24. Giannantoni A, Silvestro D, Siracusano S, Azicnuda E, D’ippolito M, Rigon J, Sabatini U, Bini V, Formisano R. Urologic dysfunction and neurologic outcome in coma survivors after severe traumatic brain injury in the postacute and chronic phase. Arch Phys Med Rehabil. 2011;92:1134–8.

    Article  PubMed  Google Scholar 

  25. Weld KJ, Dmochowski RR. Association of level of injury and bladder behaviour in patients with post-traumatic spinal cord injury. Urology. 2000;55(4):490–4.

    Article  CAS  PubMed  Google Scholar 

  26. Agrawal M, Joshi M. Urodynamic patterns after traumatic spinal cord injury. J Spinal Cord Med. 2015;38(2):128–33.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kaplan SA, Chancellor MB, Blaivas JG. Bladder and sphincter behaviour in patients with spinal cord lesions. J Urol. 1991;146(1):113–7.

    Article  CAS  PubMed  Google Scholar 

  28. Wyndaele JJ. A critical review of urodynamic investigations in spinal cord injury patients. Paraplegia. 1984;22:138–44.

    PubMed  CAS  Google Scholar 

  29. Wyndaele JJ. Correlation between clinical neurological data and urodynamic function in spinal cord injured patients. Spinal Cord. 1997;35:213–6.

    Article  CAS  PubMed  Google Scholar 

  30. Moslavac S, Dzidic I, Kejla Z. Neurogenic detrusor overactivity: comparison between complete an incomplete spinal cord injury patients. Neurourol Urodyn. 2008;27(6):504.

    Article  CAS  PubMed  Google Scholar 

  31. Blaivas JG, Sinha HP, Zayed AA, Labib KB. Detrusor-external sphincter dyssynergia. J Urol. 1981;125(4):542–4.

    Article  CAS  PubMed  Google Scholar 

  32. Rudy DC, Awad SA, Downie JW. External sphincter dyssynergia: an abnormal continence reflex. J Urol. 1988;140(1):105–10.

    Article  CAS  PubMed  Google Scholar 

  33. Siroky MB, Krane RJ. Neurologic aspects of detrusor-sphincter dyssynergia, with reference to the guarding reflex. J Urol. 1982;127(5):953–7.

    Article  CAS  PubMed  Google Scholar 

  34. Kneist W, Wachter N, Paschold M, Kauff DW, Rink AD, Lang H. Midterm functional results of taTME with neuromapping for low rectal cancer. Tech Coloproctol. 2016;20:41–9.

    Article  CAS  PubMed  Google Scholar 

  35. Long Y, Yao DS, Pan XW, Ou TY. Clinical efficacy and safety of nerve-sparing radical hysterectomy for cervical cancer: a systematic review and meta-analysis. PLoS One. 2014;9(4):e94116.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Costa P, Perrouin-Verbe B, Colvez A, Didier J, Marquis P, Marrel A, Amarenco G, Espirac B, Leriche A. Quality of life in spinal cord injury patients with urinary difficulties. Development and validation of qualiveen. Eur Urol. 2001;39(1):107–13.

    Google Scholar 

  37. Forchheimer M, McAweeney M, Tate DG. Use of the SF-36 among persons with spinal cord injury. Am J Phys Med Rehabil. 2004;83(5):390–5.

    Google Scholar 

  38. Ku JH. Health-related qulaity of life in patients with spinal cord injury: review of the short form 36-health questionnaire survey. Yonsei Med J. 2007;48(3):360–70.

    Google Scholar 

  39. Shenot PJ, Rivas DA, Watanabe T, Chancellor MB. Early predictors of bladder recovery and urodynamics after spinal cord injury. Neurourol Urodyn. 1998;17:25–9.

    Article  CAS  PubMed  Google Scholar 

  40. Schurch B, Iacovelli V, Averbeck M, Stefano C, Altaweel W, Agro EF. Urodynamics in patients with spinal cord injury: a clinical review and best practice paper by a working group of the international continence society urodynamics committee. Neurourol Urodyn. 2018;37:581–91.

    Article  PubMed  Google Scholar 

  41. De EJB, Patel CY, Tharian B, Westney OL, Graves DE, Hairston J. Diagnostic discordance of electromyography (EMG) versus voiding cystourethrogram (VCUG) for detrusor-external sphincter dyssynergy (DESD). Neurourol Urodyn. 2005;24:616–21.

    Article  PubMed  Google Scholar 

  42. Radley SC, Rosario DJ, Chapple CR, Farkas AG. Conventional and ambulatory urodynamic findings in women with symptoms suggestive of bladder overactivity. J Urol. 2001;166(6):2253–8.

    Article  CAS  PubMed  Google Scholar 

  43. Pannek J, Pieper P. Clinical usefulness of ambulatory urodynamics in the diagnosis and treatment of lower urinary tract dysfunction. Scand J Urol Nephrol. 2008;42(5):428–32.

    Article  PubMed  Google Scholar 

  44. Van Waalwijk van Doorn ES, Remmers A, Janknegt RA. Extramural ambulatory urodynamic monitoring during natural filling and normal daily activities: evaluation of 100 patients. J Urol. 1991;146(1):124–31.

    Article  CAS  PubMed  Google Scholar 

  45. Martens FM, Van Kuppevelt HJ, Beekman JA, Heijnen IC, D’Hauwers KW, Heesakkers JP. No primary role of ambulatory urodynamics for the management of spinal cord injury patients compared to conventional urodynamics. Neurourol Urodyn. 2010;29(8):1380–6.

    Article  CAS  PubMed  Google Scholar 

  46. Salvatore S, Khullar V, Cardozo L, et al. Evaluating ambulatory urodynamics: a prospective study in asymptomatic women. BJOG. 2001;108(1):107–11.

    PubMed  CAS  Google Scholar 

  47. Salvatore S, Khullar V, Anders K, Cardozo LD. Reducing artefacts in ambulatory urodynamics. Br J Urol. 1998;81(2):211–4.

    Article  CAS  PubMed  Google Scholar 

  48. Robertson AS. Behaviour of the human bladder during natural filling: the Newcastle experience of ambulatory monitoring and conventional artificial filling cystometry. Scand J Urol Nephrol Suppl. 1999;201:19–24.

    Article  CAS  PubMed  Google Scholar 

  49. Averbeck MA, Madersbacher H. Follow-up of the neuro-urological patient: a systematic review. BJU Int. 2015;115:S39–46.

    Article  Google Scholar 

  50. Bruschini H, Almeida FG, Srougi M. Upper and lower urinary tract evaluation of 104 patients with myelomeningocele without adequate urological management. World J Urol. 2006;24:224–8.

    Article  PubMed  Google Scholar 

  51. McGuire EJ, Woodside JAAR, Borden TA, Weiss RM. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol. 1981;126(2):205–9.

    Article  CAS  PubMed  Google Scholar 

  52. Jamil F, Williamson M, Ahmed YS, Harrison SC. Natural-fill urodynamics in chronically catheterized patients with spinal-cord injury. BJU Int. 1999;83(4):396–9.

    Article  CAS  PubMed  Google Scholar 

  53. Gerridzen RG, Thijssen AM, Dehoux E. Risk factors for upper tract deterioration in chronic spinal cord injury patients. J Urol. 1992;147:416–8.

    Article  CAS  PubMed  Google Scholar 

  54. Hackler RH. A 25-year prospective mortality study in the spinal injured patient: comparison with the long-term living paraplegic. J Urol. 1977;117:486–8.

    Article  CAS  PubMed  Google Scholar 

  55. Feifer A, Corcos J. Contemporary role of suprapubic cystostomy in treatment of neuropathic bladder dysfunction in spinal cord injured patients. Neurourol Urodyn. 2008;27:475–9.

    Article  PubMed  Google Scholar 

  56. Weld KJ, Dmochowski RR. Effect of bladder management on urological complications in spinal cord injured patients. J Urol. 2000b;163(3):768–72.

    Article  CAS  PubMed  Google Scholar 

  57. Wyndaele JJ, Madersbacher H, Kovindha A. Conservative treatment of the neuropathic bladder in spinal cord injured patients. Spinal Cord. 2001;39:294–300.

    Article  CAS  PubMed  Google Scholar 

  58. Chancellor MB, Anderson RU, Boone TB. Pharmacotherapy for neurogenic detrusor overactivity. Am J Phys Med Rehabil. 2006;85:536–45.

    Article  PubMed  Google Scholar 

  59. Amend B, Hennenlotter J, Schäfer T, Horstmann M, Stenzl A, Sievert KD. Effective treatment of neurogenic detrusor dysfunction by combined high-dosed antimuscarinics without increased side-effects. Eur Urol. 2008;53:1021–8.

    Article  CAS  PubMed  Google Scholar 

  60. Horstmann M, Schaefer T, Aguilar Y, Stenzl A, Sievert KD. Neurogenic bladder treatment by doubling the recommended antimuscarinic dosage. Neurourol Urodyn. 2006;25:441–5.

    Google Scholar 

  61. Wada N, Shimizu T, Takai S, Shimizu N, Tyagi P, Kakizaki H, Yoshimura N. Neurourol Urodyn. 2017;36:1039–45.

    Article  CAS  PubMed  Google Scholar 

  62. Wöllner J, Pannek J. Initial experience with the treatment of neurogenic detrusor overactivity with a new ß-3 agonist (mirabegron) in patients with spinal cord injury. Spinal Cord. 2016;54(1):78–82.

    Article  PubMed  Google Scholar 

  63. Ginsberg D, Gousse A, Keppenne V, Sievert KD, Thompson C, Lam W, Brin MF, Jenkins B, Haag-Molkenteller C. J Urol. 2012;187(6):2131–9.

    Article  CAS  PubMed  Google Scholar 

  64. Hohenfellner M, Pannek J, Böte U, Dahms S, Pfitzenmaier J, Fichtner J, Hutschenreiter G, Thüroff JW. Sacral bladder denervation for treatment of detrusor hyperreflexia and autonomic dysreflexia. Urology. 2001;58(1):28–32.

    Article  CAS  PubMed  Google Scholar 

  65. Mehta S, Hill D, McIntyre A, Foley N, Hsieh J, Ethans K, Reasell R, Loh E, Welk B, Wolfe D. Meta-analysis of botulinum toxin A detrusor injections in the treatment of neurogenic detrusor overactivity after spinal cord injury. Arch Phys Med Rehabil. 2013;94(8):1473–81.

    Article  PubMed  Google Scholar 

  66. Quek ML, Ginsberg DA. Long-term urodynamics follow-up of bladder augmentation for neurogenic bladder. J Urol. 2003;169:195–8.

    Article  PubMed  Google Scholar 

  67. Wöllner J, Krebs J, Pannek J. Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54(2):137–40.

    Article  PubMed  Google Scholar 

  68. Brindley GS. The first 500 patients with sacral anterior root stimulator implants: general description. Paraplegia. 1994;32(12):795–805.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Radboudumc, Nijmegen, The Netherlands

    Frank M. J. Martens

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Correspondence to Frank M. J. Martens .

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Editors and Affiliations

  1. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA

    Roger Dmochowski

  2. Department of Urology, Radboud University, Nijmegen, The Netherlands

    John Heesakkers

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Martens, F.M.J. (2018). Traumatic Lesions. In: Dmochowski, R., Heesakkers, J. (eds) Neuro-Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-90997-4_6

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  • DOI: https://doi.org/10.1007/978-3-319-90997-4_6

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