Does autonomic nervous system dysfunction impact on ureteric jet Doppler waveform formation in patients with neurogenic bladder related to spinal cord injury?

Abstract

Background: Autonomic nervous system (ANS) dysfunction in individuals with spinal cord injury (SCI) may have an impact on Ureteric Jet Doppler Waveform (UJDW) types.

Objective: The aims of the study were (1) to determine UJDW types in individuals with SCI, (2) to evaluate the factors that affect these UJDW types, and (3) to examine the possible indirect effect of ANS dysfunction on these UJDW types.

Materials and methods: This cross-sectional study included twenty individuals with SCI (study group) and twenty-four healthy volunteers (control group). The appearance of UJDW forms and bladder wall thicknesses were collected by urinary Doppler ultrasound (USG) in both groups. Bladder pressure and abdominal pressure were recorded when the bladder was full after Doppler USG examination.

Results: The most common types of UJDW detected in participants with SCI were monophasic and biphasic wave patterns. When the study group and control groups were compared in terms of UJDW types, monophasic wave percentage median values were higher in the study group than in the control group (p = 0.001). The median values of the percentage of biphasic waves were higher in individuals with lesion level ≤ thoracic (T) 7 compared to individuals with lesion level ≥ T6 (p = 0.011). The monophasic wave form was not found at a higher rate in individuals with lesion level ≥ T6 level compared to the individuals with lesion level ≤ T7.

Conclusion: The findings of this study may suggest that the monophasic form is not evidence of ANS dysfunction in individuals with SCI.