1981 Volume 72 Issue 7 Pages 880-891
Thirty-four cases with micturitional disturbance (24 male and 10 female) resulting from cerebrovascular accidents were examined by recording urethral pressure profile (UPP), cystometrogram and external sphincter electromyogram. The site of the lesions of these subjects were diagnosed by neurological examination, cerebral angiography and brain computed tomography.
By correlation of these data, the following conclusions were obtained.
1) Cystometry showed hyperactive bladder in 25 cases (74%) of the 34 cases examined, and external sphincter electromyography demonstrated normal sphincter in 14 cases (50%).
2) In cases with putaminal lesion, cystometry showed hyperactive bladder frequently (78%) but external sphincter electromyography demonstrated that external sphincter remined under volitional control (67%).
3) In cases with frontal and/or internal capsular lesion, cystometry demonstrated hyperactive bladder commonly (89%) and external sphincter electromyography tended to show uninhibited reflex relaxation with detrusor hyperreflexia (56%).
4) In most of the cases whose cystometry showed inactive bladder, atrophic change was revealed in the whole brain by brain computed tomography. In these cases we cannot deny the possibility that atrophic change may occur in the pontine-mesencephalic reticular formation where the detrusor motor center is believed to be present.
