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Journal of the Korean Academy of Rehabilitation Medicine 1993;17(1):86-94.
The problems of bladder overdistention in patients with spinal cord injury.
Rah, Ueon Woo , Hwang, Kyeong Sang , Park, Jun Sung
Department of Rehabilitation Medicine, Yonsei University College of Medicine and Wonju College of Medicine*
척수손상환자에서 방광의 과대팽창으로 인한 문제점에 대한 고찰
나은우, 황경상*, 박준성*
연세대학교 의과대학 및 원주의과대학* 재활의학교실

The purpose of this study was to review the problems of bladder overdistention and to analyze the effects on bladder training in the patients with spinal cord injury. The subjects of study were 34 spinal cord injured patients with neurogenic bladder dysfunction.

Of the total of 34 patients, 28 patients (82.4%) experienced bladder overdistention in early phase of spinal cord injury. Assuming that the detrusor, internal urethral sphincter, and external urethral sphincter muscles of 24 patients become hyperreflexic (Group I), detrusor areflexia was seen in four of the 20 patients with overdistended bladder. In four patients with detrusor areflexia, the amount of bladder volume was over 1,000 cc. The recovery of detrusor reflex was delayed in 16 patients with experience of overdistened bladder and significant correlation between time of recovery of detrusor reflex and frequency of bladder overdistention.

Assuming that the detrusor and external urethral sphincter muscles of ten patients become areflexic (Group II), bladder overdistention did not affect the achievement of a balanced bladder or the time required for this.

Therefore, we conclude that bladder overdistention do not cause irreversible damage to the detrusor muscle but delayed recovery of detrusor reflex. The prevention of bladder overdistention is very important in the early management of neurogenic bladder in the patients with spinal cord injury.

Key Words: Neurogenic bladder, Bladder overdistention, Balanced bladder


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