Cardiovascular Monitoring During Video Urodynamic Studies in Persons With Spinal Cord Injury.

Abstract

The aims of the study were to observe cardiovascular responses during video urodynamic studies and to identify correlations between autonomic dysreflexia events and video urodynamic study findings in spinal cord injuries. Thirty-four persons with spinal cord injury were enrolled and investigated using continuous cardiovascular monitoring during video urodynamic studies. Associations between cardiovascular responses and video study variables were analyzed. Bladder type-specific cardiovascular responses occurred during the study. The incidence of overactive detrusor during urodynamic study and bladder trabeculation on voiding cystourethrogram was significantly higher in autonomic dysreflexia persons with spinal cord injury (P < 0.05). Systolic blood pressure changes showed moderate negative correlation (r = -0.402, P = 0.020) with bladder compliance and high positive correlation (r = 0.810, P = 0.000) with maximum detrusor pressure. However, no significant differences in neurological level of injury, injury completeness, autonomic dysreflexia symptoms, and voiding type were found. Spinal cord injury increase at each section was significantly higher in overactive detrusor group (P < 0.05). Significant bradycardia or tachycardia correlating with autonomic dysreflexia during urodynamic studies was not observed. Unpredictable cardiovascular reactions during urodynamic study should be considered carefully in persons with a spinal cord injury above T6. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Describe limitations of previous cardiovascular monitoring during urodynamic study to observe changes in cardiovascular responses; (2) Identify factors contributing to autonomic dysreflexia during urodynamic testing; and (3) Discuss the effect of morphologic features in voiding cystourethrogram including trabeculation and vesicourethral reflux on autonomic dysreflexia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.