Urodynamics for Spinal Cord Injury – How, When, Why

Patients with spinal cord injury (SCI) often have lower urinary tract dysfunction. Their urological dysfunction should be managed as part of their overall holistic care in a specialist SCI unit. Whilst level of disease can cause broad categories of urological problems, lower urinary tract symptoms may be complex and difficult. Urodynamic studies investigate the urinary tract by measurement of flow and pressure. Urodynamic studies perform an important role in the urological management of patients with SCI. Invasive video urodynamic studies are the gold standard urodynamics of choice in these patients due to the extra information that can be gleaned from fluoroscopy. The major complication of neurogenic lower urinary tract dysfunction is of a risk to the upper tracts. Baseline urodynamic studies are performed in patients with SCI to assess symptoms and risk to the upper tracts, so that management can be planned accordingly. The optimum follow-up schedule for urodynamics remains controversial.