title: Differences in urodynamic variables for vesicoureteral reflux depending on the neurogenic bladder type.
abstract: OBJECTIVE
  To compare the urodynamic study variables at the onset of vesicoureteral reflux (VUR) between the overactive and underactive bladders in patients with spinal cord injury who presented with VUR.
  
  
  METHODS
  A total of 28 (13 cases of detrusor overactivity and 15 detrusor underactivity) men were enrolled. We compared the urodynamic variables between the two groups; detrusor pressure and bladder compliance, the infused volume at the onset of VUR measured on a voiding cystourethrography and cystometric capacity, maximum detrusor pressure, and bladder compliance during filling cystometry were recorded.
  
  
  RESULTS
  At the onset of VUR, the bladder volume and compliance, except for the detrusor pressure, showed a significant difference between the two groups. The detrusor pressure, bladder volume, and bladder compliance relative to the cystometric capacity showed a significant difference between the two groups. The detrusor pressure, bladder volume, and bladder compliance at the onset of VUR relative to the cystometric bladder capacity did not show any significant difference between the two groups.
  
  
  CONCLUSIONS
  There were differences in some variables at the onset of VUR depending on the type of neurogenic bladder. The VUR occurred at a lower capacity in neurogenic bladder with detrusor overactivity than in neurogenic bladder with detrusor underactivity at the same pressure. VUR occurred at a lower intravesical pressure compared to that known as the critical detrusor pressure (≥40 cm H2O) required for the development of VUR. The results of our study demonstrate that the detrusor pressure should be maintained lower than the well known effective critical detrusor pressure for the prevention and treatment of VUR.
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Medical Research Institute, Pusan National University, Busan, Korea.
authors.forename: Je Sang
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Bon Il
authors.initials: BI
authors.lastname: Koo
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Medical Research Institute, Pusan National University, Busan, Korea.
authors.forename: Myung Jun
authors.initials: MJ
authors.lastname: Shin
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Medical Research Institute, Pusan National University, Busan, Korea.
authors.forename: Jae Hyeok
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Soo-Yeon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Division of Spinal Cord Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Korea. ; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hyun-Yoon
authors.initials: HY
authors.lastname: Ko
keywords: Neurogenic urinary bladder; Spinal cord injuries; Urodynamics; Vesicoureteral reflux