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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 determinedResults: 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. Turk J Phys Med Rehab 2011;57:80-4. |
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