title: Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?
abstract: OBJECTIVE
  To observe neurogenic bladder pattern in patients with myelopathy by performing urodynamic study (UDS) and to observe whether it has any correlation with functional and neurological recovery.
  
  
  METHODS
  This prospective study was conducted with 90 patients with myelopathy, both traumatic and non-traumatic (males = 65) in a university tertiary research hospital in India between January 2011 and December 2013. Mean age was 33.5 ± 13.2 years (range 15-65 years), mean duration of injury was 82.63 ± 88.3 days (range 14-365 days) and mean length of stay (LOS) in the rehabilitation unit 42.5 ± 23.3 days (range 14-130 days). The urodynamic study was performed in all the patients to assess the neurogenic bladder pattern. Management was based on the UDS findings. Functional recovery was assessed using Barthel index (BI) scores and spinal cord independence measures (SCIM) scores. Neurological recovery was assessed using ASIA impairment scale (AIS). We tried to correlate neurogenic bladder patterns with recovery.
  
  
  RESULTS
  Fifty patients (55.6%) had overactive detrusor with 25 each had detrusor sphincter dyssynergia (DSD) and synergic sphincter. Thirty-eight patients had hypoactive/acontractile detrusor and two had normal studies. No significant correlation observed between neurogenic bladder pattern and change in BI scores (P = 0.696), SCIM scores (P = 0.135) or change in ASIA status (P = 0.841) in the study.
  
  
  CONCLUSIONS
  More than half of the patients with myelopathies had overactive detrusor with or without dyssynergic sphincter according to the urodynamic study. Neurogenic bladder patterns had no significant correlation with functional and neurological recovery in these patients.
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Menon
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
authors.forename: Anupam
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
authors.forename: Arun B
authors.initials: AB
authors.lastname: Taly
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
authors.forename: Meeka
authors.initials: M
authors.lastname: Khanna
authors.affiliation: Department of Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India.
authors.forename: Sushruth Nagesh
authors.initials: SN
authors.lastname: Kumar
keywords: Functional and neurological outcomes; myelopathies; urodynamic studies