Turkish Journal of Physical Medicine and Rehabilitation 2011 , Vol 57 , Num 2
Urodynamic Findings in Patients with Traumatic Brain Injury
Murat Ersöz 1 ,Kurtuluş Kaya 2 ,Selami AKKUŞ 3 ,Sumru Özel 4
1 Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
2 Tatvan Devlet Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Bitlis, Türkiye
3 Yıldırım Beyazıt Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara, Türkiye
4 Clinic of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
DOI : 10.4274/tftr.57.16

Objective: The aim of this study was to investigate the urodynamic findings and characteristics of lower urinary tract dysfunction in patients with traumatic brain injury (TBI).

 

Materials and Methods: Thirty patients (25 male, 5 female) with TBI, who had neurogenic lower urinary tract dysfunction, were investigated retrospectively. Urodynamic examinations were performed, maximum cystometric capacity, residual urine, presence of storage dysfunction (bladder capacity<300 ml) and emptying dysfunction (residual urine >50 ml), and presence of bladder filling sensation, type of detrusor activity and bladder emptying method were determined

 

Results: The mean age of the subjects was 31.9±16.3 years. The mean maximum cystometric capacity was 228±155 ml. Postvoiding residual urine was present in 15 patients and the mean residual urine was 128±143 ml. Bladder filling sensation was normal in 16 (55.2%), diminished in 11(37.9%) and was absent in 2(6.9%). Frequencies of storage and emptying dysfunctions were 20 (66.7%) and 8 (26.7%), respectively and 4 patients (13.3%) had both storage and emptying dysfunctions. Three patients (10%) had normoactive, 23 (76.7%) had overactive and 4 (13.3%) had underactive detrusor. Twenty-five patients (83%) were emptying their bladder spontaneously, 4 (13.3%) by intermittent catheterization and 1(3.3%) by indwelling catheter. Nine (36%) of the 25 patients who were emptying their bladder spontaneously were using urinary condom, 2 (8%) were using diapers. In the evaluation of nine patients who were given  anticholinergic/antispasmodic therapy and had control urodynamic investigation pre- and post-treatment, the median values of cystometric capacities were 99 (min: 48-max: 420) and 158 (min: 52-max: 448) ml, respectively. Increase in cystometric capacity was observed in eight of nine patients.

 

Conclusion: Bladder storage dysfunction is frequent in patients with TBI which is mainly due to detrusor overactivity. Bladder filling sensation was present at least to some degree in the great majority of them and again, a great majority of the patients were able to void spontaneously. 

Keywords : Traumatic brain injury, urodynamics, overactive detrusor, bladder filling sensatio