Variable Findings of Urodynamic Study in Patients with Cerebrovascular Accident Diagnosed as Detrusor Hyperreflexia.
- Author:
Ji Hyun LEE
1
;
Young Joo KIM
;
Choong Hyun LEE
Author Information
1. Department of Urology, Kyung Hee University, School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cerebrovascular accident;
Urodynamics;
Hyperreflexia
- MeSH:
Ataxia;
Humans;
Reflex, Abnormal*;
Stroke*;
Urodynamics*
- From:Korean Journal of Urology
2004;45(3):240-244
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We classified DH(detrusor hyperreflexia) into variable urodynamic findings as DHIC(detrusor hyperreflexia with impaired contractility), DHDP(detrusor hyperreflexia with dyssynergia pattern), and NCDDH(non-impaired contractility < non-dyssynergia pattern detrusor hyperreflexia). The aim of this study was to elucidate the reliability of the difference among the classified DH through a urodynamic study. MATERIALS AND METHODS: Sixty-nine patients showed DH, which was defined as an involuntary detrusor contraction of more than 15cmH2O with involuntary urine leakage with only a cerebrovascular accident (CVA), by urodynamic study. We classified DH(n=69) into three subgroups as DHIC(n=22)(Pdet.max<30cmH2O, Qmax<12ml/s), DHDP (n=19)(Pdet.max>50cmH2O, Qmax<12ml/s), and NICNDP-DH(n=28). RESULTS: Mean fraction of voided volume of DHIC(41.7+/-1.8%) and DHDP (38.3+/-2.2%) were significantly less than that of NCDDH (98.5+/-3.2%) according to the urodynamic study (p<0.01). Mean voiding pressure was 25.8+/-0.7cmH2O in DHIC, which was significantly less. However, 96.3+/-10.4cmH2O in DHDP was significantly more than that of NCDDH(p<0.01). Mean age was 83.8+/-1.2 years old in DHIC, which was significantly older than the mean age of the other groups(p=0.01). CONCLUSIONS: Variable findings of the urodynamic study were found in patients with DH as clinical parameters. Thus, we must treat the DH patients with individual therapy based on urodynamic findings.
