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A 27-year-old man sustained a T6 spinal cord injury 18 months ago. He is not on
any medication.
1. What is happening in this trace?
2. What type of bladder will demonstrate this tracing?
3. What complication can result from this type of bladder dysfunction?
4. What is the optimal treatment for this type of bladder disorder?


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Answer to the case
1. Case 1-3-7 shows high-pressure sustained detrusor overactivity with a pressure
rising to around 80 cmH2O. The contraction is also sustained, lasting for more
than 5 min.
2. This is the classical urodynamic traces seen with an upper motor neuron type of
spinal cord injury, resulting in high-pressure neurogenic detrusor overactivity,
characterised by a ‘saw toothed’ appearance to the detrusor trace.
3. This can lead to small volume, thick-walled bladder with ureteric reflux and
upper tract decompensation. Renal failure may ensue.
4. This patient should be on anti-cholinergic medication and practice intermittent

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