1) Sixty-one patients after cerebrovascular accidents were simultaneously evaluated by cystometry and anal sphincter EMG. Their ages ranged from 36 to 86 years, with an average of 64. The cerebrovascular accidents experienced by these subjects consisted of cerebral infarction in 25 cases, cerebral bleeding in 24 and subaracnoidal hemorrhage in 12. The mean interval from onset of the cerebrovascular accident to the urodynamic study was 225 days, ranging from 36 to 3041 days. Forty-eight of the patients had urinary symptoms.
2) Seventy-three percent of the patients with urinary symptoms had an overactive bladder, and 56% had a normal urethra. Only 8% of the patients showed detruser-sphincter dyssynergia. Unexpectedly, the patients without symptoms also showed abnormal lower urinary tract function.
3) The chief complaints of the patients with urinary symptoms were urinary incontinence, frequency and the use of an indwelling catheter. Dysuria was not a complaint, but some patients who had residual urine were among the patients whose complaint was incontinence or frequency. The urinary symptoms were well explained by a urodynamic test (combined with cystometry and sphincter EMG). But patients who had residual urine were also found among those who had an overactive bladder with either incompetent or normal urethra. Therefore we consider that these patients cannot be correctly evaluated by cystometry and sphincter EMG.
4) The patients who had an overactive bladder with incompetent urethra were in more serious condition than other groups according to Brunnstrom stage, and ADL. Moreover they had more aphasia or unilateral spatial neglect often than others.
5) Regarding the correlation between the location of brain damage and the urodynamic study, half of the patients whose lesions were located in the frontal lobe or posterior limb of internal capsule had an overactive baldder with incompetent urethra, but the other half of them showed other patterns. Five of the 8 patients whose lesions were only in the putamen had an overactive bladder with normal urethra, but the remaining 3 showed other patterns. Therefore there was no obvious correlation between urodynamic dysfunction and the location of brain damage.

View full abstract