The use of one-channel water cystometry in patients with a spinal cord lesion: Practicalities, clinical value and limitations for the diagnosis of neurogenic bladder dysfunction

Abstract

Study design:Investigational technique evaluation.Objective:To evaluate the clinical value and limitations of one-channel cystometry as a method for urodynamic testing in patients with spinal cord lesion (SCL).Setting:Spinal Cord Injury Centers Asia.Methods:Protocol, equipment and practical performance of the one-channel cystometry as used in Ho Chi Minh City and Chiang Mai were studied.Results:One-channel cystometry permits to accurately evaluate bladder pressure development at constant filling speed. It shows detrusor muscle behaviour as detrusor overactivity and allows evaluating sensation of bladder filling. It can strongly suggest detrusor external sphincter dyssynergia. The need of bladder-relaxant drugs and their effectiveness can be evaluated. The major limitation is that the one pressure line will show changes of intravesical pressure independent of their cause, which makes a continuous thorough observation mandatory throughout the test. Other limitations are a filling rate higher than physiological and a filling solution at room temperature. As in more elaborate urodynamic testing, the observations do therefore not necessarily reflect the function of the lower urinary tract in daily life.Conclusion:One- channel cystometry is easy to perform, cheap and clinically valid. The results need to be integrated in the overall knowledge of the patient's neurological situation. The method permits one to gather a lot of information on bladder function in persons with SCL. With proper interpretation and a clear understanding of the shortcomings, it is a good guide for bladder management. It is applicable everywhere. © 2009 International Spinal Cord Society All rights reserved.