Urodynamic evaluation and rehabilitation outcomes in transverse myelitis

OBJECTIVE: To evaluate micturition abnormalities in patients with transverse myelitis (TM) using urodynamic studies, and to record functional outcomes of these patients after the rehabilitation program.METHODS: Forty-six patients with TM who attended the Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey between January 2000 and June 2005 were included in the study. Demographic findings of patients were documented. A history and detailed neurological examination was performed on all patients. Urological symptoms and history of bowel and sexual involvement were recorded. Urodynamic investigations were carried out for each patient. All patients were enrolled in the rehabilitation program. Neurologic bladder types and treatments, and functional levels of the patients after the rehabilitation program were recorded.RESULTS: Twenty-two men and 24 women were evaluated. The mean age was 39.74+/-15.94 (15-75) years, mean illness duration was 800.24+/-885.49 (150-3600) days. Thirty-six patients had paraplegia and 10 had tetraplegia. Thirty patients had a history of urinary pathology, 32 had bowel pathology, and 6 had sexual pathology. Urodynamic studies showed hypocompliant bladder in 2 patients, detrusor sphincter dyssynergia in 22, detrusor hyperreflexia in 16, and only sphincter disorder in 6 patients. Functional outcomes on discharge were independent ambulation in 8, ambulation with crutches in 16, ambulation with knee-ankle-foot orthesis and crutches in 4, therapeutic ambulation in 2, wheelchair in 16.CONCLUSION: Rehabilitation is important in patients with TM to continue the urinary continence and to preserve renal function, to obtain functional independence and to prevent complications.