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A 34-year-old woman with T8 level spinal cord injury complains of frequency and urgency.
1. Does this trace show neurogenic detrusor overactivity?
2. Why does the detrusor pressure start to drop?
3. What is the voiding pressure?
4. What is the explanation for the rise of pressure after voiding?


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Answers to CaAse1-3-8
1. There is no neurogenic detrusor overactivity as the detrusor line rises in a straight
line without any non-phasic contractions. However, the rise in detrusor pressure
indicates a loss of compliance.
2. The pressure drops when the pump is stopped. Fast filling may show an apparent
poor compliance with a rise in pressure during filling, but when the pump is
stopped the pressures should decline. A fi nal pressure that remains high once the
pump is stopped confirms reduced compliance.
3. The voiding pressure is around 30 cmH 2 O.
4. The rise in pressure can sometimes occur in high-pressure bladders called ‘aftercontraction’.
The pressure here is around 90 cmH 2 O. The clinical relevance of
after contractions is still a matter of speculation.

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