Article

Retrospective chart review.Objective:To compare autonomic
dysreflexia (AD) severity during urodynamics and cystoscopy in individuals with
spinal cord injury (SCI).Setting:Outpatient urological clinic.Methods:Demographic
and clinical data were collected from charts of individuals with SCI who had
blood pressure (BP) monitoring during urological procedures. Cardiovascular
parameters were collected at baseline and during the various stages of two
examinations.Results:A total of 21 SCI individuals (mean age 49.4 years) who
underwent both procedures developed episodes of AD. The majority of individuals
had cervical SCI (85.7%). The median duration of injury was 183 months (ranging
from 3 to 530 months). There was statistically more of an increase (P=0.039) in
systolic BP during cystoscopy (67.1+/-33.8 mm Hg) in comparison with urodynamics
(51.8+/-21.8 mm Hg). The BP response during episodes of AD was more pronounced in
individuals with more than 2 years post SCI than with less than 2 years post SCI
during both urodynamics and cystoscopy (P=0.047 and P=0.010,
respectively).Conclusion:Even though cystoscopy filled the bladder to lesser
volumes than did urodynamics (150 ml vs 500 ml), during cystoscopy the
individuals developed greater changes in systolic BP, indicating that stimulation
of the urethra/prostate/internal sphincter region probably is a more potent
stimulus of AD than just the filling of the bladder. The severity of AD also
increased with time post SCI during both procedures. Considering the high
incidence of silent episodes of AD during the urological procedures, it is
recommended that monitoring of cardiovascular parameters during these procedures
be routinely performed.

Langue : ANGLAIS