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. 2024 Jul 8;5(8):761-769.
doi: 10.1002/bco2.370. eCollection 2024 Aug.

Indications and added value of videourodynamics in men with spinal cord injury

Marc Françot  1 , Chloé Lefevre  2 , Bénédicte Reiss  2 , Marc Lefort  2 , Georges Karam  1 , Jerome Rigaud  1 , Loic Le Normand  1 , Alain Ruffion  3 , Brigitte Perrouin-Verbe  2 , Marie-Aimee Perrouin-Verbe  1
Affiliations

Indications and added value of videourodynamics in men with spinal cord injury

Marc Françot et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Purpose: The primary aim of this study was to evaluate the indications and additional information provided by videourodynamic study (VUDS) over urodynamic studies (UDS) in men with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD). The secondary aim was to determine the added value of VUDS and its impact on bladder management.

Materials and methods: Single-centre retrospective study of all men with SCI who underwent VUDS between 2011 and 2021. Participant characteristics, clinical data and indications for UDS and VUDS as well as bladder management were recorded. The added value of VUDS was defined as additional information not provided by standard UDS that impacted on bladder management (choice of voiding mode, surgical indication or type of surgery).

Results: Eighty-eight men with a median age of 52 years were included. In 20 men who were unable to perform self-catheterisation, the VUDS clarified the nature and extent of the obstruction and enabled targeted surgery to achieve reflex bladder emptying in all of them. VUDS also clarified the type and level of obstruction in 28 patients, enabling targeted surgery in 24. In 11 men, VUDS was performed as part of the preoperative assessment for a Brindley procedure or after this operation if a complication occurred during follow-up to confirm the need for further surgery or to target surgical revision. Overall, VUDS had added value in 59 patients (67%).

Conclusions: VUDS had added value over UDS in specific situations; the additional information provided impacted on bladder management in men with SCI and NLUTD.

Keywords: detrusor sphincter dyssynergia; endoscopic sphincterotomy; neurogenic lower urinary tract dysfunction; spinal cord injury; urodynamic study; video‐urodynamic study.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
VUDS confirming detrusor sphincter dyssynergia. UDS traces (2A): BOO with prolonged detrusor contraction, with high amplitude. At the end of contraction, leakage is observed during intermittent opening of the striated sphincter. In video (2B), a wide opening of the bladder neck with dilatation of the proximal urethra over a narrow striated sphincter is observed during detrusor contraction, confirming an isolated striated DSD, without detrusor bladder neck dyssynergia. At the end of the contraction, there is an intermittent opening of the striated sphincter with leakage of contrast into the urethra (link to video).
FIGURE 2
FIGURE 2
Video urodynamic examination confirming BOO at the level of the prostate. On UDS traces, BOO is observed (high detrusor pressure during voiding, associated with a low flow). On the video, the outline of the prostatic gland is marked in red and the course of the prostatic urethra in blue. Source: Pictures from Abrams' Urodynamics 4th Edition.
FIGURE 3
FIGURE 3
Indications for VUDS in the bladder management of male patients with SCI.
See this image and copyright information in PMC

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