What is the pathogenesis of neurogenic bladder following the spinal shock phase of a SCI?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

When the spinal shock phase wears off, bladder function returns but the detrusor activity increases in reflex excitability to an overactive state (ie, detrusor hyperreflexia). Depending on the level of the lesion, detrusor sphincter dyssynergia–detrusor hyperreflexia (DSD-DH) may develop. Thus, these patients must be monitored for leaking between CIC, and periodic urodynamic testing must be performed for this alteration in detrusor behavior. During urodynamic studies, intravesical instillation of cold saline may indicate return of reflex activity or help better characterize the lesion.


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