The aim of the management of neurogenic bladder in spinal cord injury patients is to achieve balanced voiding without any deleterious effects on the upper urinary tract. In establishing balanced bladder, functional evaluation and comprehensive management of neurogenic bladder is important. The purpose of this study was to review the results of bladder training in spinal cord injury patients who received urodynamic study. The subjects of this study were 48 spinal cord injury patients with neurogenic bladder dysfunction who were admitted to Severance Hospital, Yonsei University, and received urodynamic study between July 1, 1987 and June 30, 1988. The results are as follows: 1) The subjects were 38 male and 10 female patients and age ranged form 4 to 66 years old. 2) The types of neurogenic bladder according to the urodynamic study did not always correlate with the spinal cord injury level. 3) Detrusor sphincter dyssynergia was found in 24 of 28 patients (85.7%) with detrusor hyperreflexia. 4) Regardless of types of neurogenic bladder, the bladder capacity and compliance were smaller, and maximum bladder capacity was higher in the late group compared to the early group (p<0.05). 5) Balanced bladder was achieved in all patients of the early group and 80% of the late group by conservative management. However with inclusion of the patients who received transurethral sphincterotomy, all patients reached balanced bladder. 6) The period of intermittent catheterization was 65 days in the early group and 16 days in the late group. 7) In the early group, the period between injury and establishment of balanced bladder was 113 days in the complete spinal cord injury patients and 85 days in the incomplete spinal cord injury patients. |