Comparison of ambulatory versus video urodynamics in patients with spinal cord injury

Abstract

To compare the data obtained through video urodynamics (VUD) with those obtained through one voiding cycle ambulatory urodynamics monitoring (AUM) in patients with spinal cord injury (SCI). A comparative study was conducted in 69 patients with SCI (mean age±s.d. 44±16.9 years), 51 men and 18 women, who were subjected to AUM and VUD. A lack of agreement was observed between the two tests with respect to the cystometric capacity (CC) (ml) (275±197.2 AUM versus 416±198.3 VUD), filling pressure (cm H2O) (4±5.3 AUM versus 9±12.5 VUD), bladder compliance (ml cm(-1) H2O) (116±114.9 AUM versus 161±179.4 VUD), maximum detrusor contraction pressure (cm H2O) (87±65.2 AUM versus 47±35.0 VUD), post-void residual (ml) (206±201.5 AUM versus 308±237.7 VUD) and stress urinary incontinence (kappa index: -0.052). Only the CC obtained in the AUM was in agreement with the mean bladder volume gathered from the frequency-volume chart. Agreement was observed with respect to the presence of neurogenic detrusor overactivity (kappa index: 0.307) and bladder outlet obstruction index (cm H2O) (17±48.0 AUM versus 15±18.7 VUD). There was no clear association between AUM parameters and bladder neck morphology, the presence of radiological detrusor-external sphincter dyssynergy or vesicoureteral reflux observed in the VUD. The differences between both methods discourage the use of AUM with just one voiding cycle in the evaluation of patients with SCI.