Urology & Urogynecology > Education and Reference

Being involved in a serious accident or the victim (sometimes perpetrator) of violent crime can result in neurologic injuries and lower urinary tract symptoms. Urodynamics would not typically be included in the acute care phase of these types of patients, but may be part of rehab/long-term follow-up care.

• Complete spinal cord disruption results in retention. These patients are catheterized or on self-cath programs.
• Patients with less serious spinal cord injuries may experience temporary symptoms of incontinence or retention, depending upon whether the sensory, motor or both pathways are affect.
• Multi- trauma from vehicle accidents, vehicle-pedestrian accidents, falls or diving accidents can result in direct injury to the urologic structures such as pelvic fractures and ruptured bladder or kidney. These types of injuries affect the local innervation.
• Head injury (cerebral/cranial trauma), if severe enough to cause a urologic symptom, causes incontinence.
• Pelvic trauma includes sacral/peripheral nerve trauma from pelvic fracture, pregnancy and childbirth, pelvic surgeries and radiation. These patients are typically incontinent.

Patients with spinal cord injury, particularly high level C-spine require special considerations and safety precautions when undergoing urodynamic studies.

Unfortunately, our bodies eventually betray us, even when we are very young in our minds and hearts. The visible condition and general appearance of the tissues of the face, chest, derriere, also reflect the condition of the structures of the pelvic floor. Gravity, hormonal changes, and a reduction in activity and general strength all affect our ability to control the micturition reflex.

In addition, mental changes and diseases associated with aging (senility, Alzheimer’s) cause urologic symptoms.

Poor bladder habits are actually a significant contributor to urologic complaints in an otherwise healthy population. Primarily, poor bladder habits fall into 3 categories:

Over-hydration
Excessive consumption of bladder irritants
Poor toileting habits

The best source of information about bladder habits is the patient interview and an Intake/Bladder Diary.