[Evidence-based medicine. Usefulness of isolated cystomanometry for the diagnosis of periurethral detrusor-sphincter dyssynergia in patients with suprasacral lesion].
OBJECTIVE
To determine the utility of cystomanometry alone in the diagnosis of periurethral detrusor-sphincter dyssynergia in patients with suprasacral spinal cord lesion.


METHODS
Cystomanometry and selective electromyography were performed to evaluate the periurethral sphincter of 40 patients (16 female and 24 male; mean age 46.6 years) with suprasacral spinal cord injury diagnosed by neurological evaluation.


RESULTS
The pre-test probability of having dyssynergia was 0.45. The post-test probability, with cystomanometrically demonstrated hyperreflexia, was 0.58. The likelihood ratio utilizing cystomanometry alone was 1.69.


CONCLUSIONS
Cystomanometry alone is not useful in the diagnosis of periurethral detrusor-sphincter dyssynergia in patients with suprasacral spinal cord injury. Periurethral electromyography should be used in combination with the foregoing technique.
Vírseda Chamorro
M
M
Servicio de Urología, Policlínica Naval, Madrid, España. bgmeli@nagasys.es
Salinas Casado
J
J
Adot Zurbano
J M
JM
Teba del Pino
F
F
Vázquez Alba
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D012447:Sacrum; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications*; D014521:Urethra / Q000503:physiopathology; D014522:Urethral Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D001743:Urinary Bladder