The determination of sensation-dependent bladder emptying time in patients with complete spinal cord injury above T11

Study design: Retrospective investigation using urodynamic studies and medical records. Objective: To evaluate the safety of sensation-dependent bladder emptying in complete spinal cord injury (SCI) patients, based on the preservation of the desire to void. Setting: Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. Methods: This study was performed retrospectively on 79 complete SCI patients with lesions above T11, who had preserved the desire to void during conventional urodynamic studies. Patients were classified according to detrusor compliance and maximal bladder capacity. The clinical and urodynamic characteristics of each group were analyzed. Results: Forty-five (57.0%) patients were classified as group A and 34 (43.0%) patients were classified as group B. There were no significant differences in clinical features, such as voiding methods and the presence of autonomic dysreflexia between the two groups. Compared with group B, there were significantly more areflexic neurogenic bladder cases in group A (P < 0.05). There were significantly higher maximal detrusor pressures in group B (P < 0.05). There were significantly more cases with the preservation of the strong desire to void in group B (P < 0.05). Conclusion: Not all patients with discomplete SCIs accepted the use of sensation-dependent bladder emptying. The safe use of sensation-dependent bladder emptying will be determined based on the results of urodynamic studies.