Acute Cerebrovascular Accident and Lower Urinary Tract Dysfunction: A Prospective Correlation of the Site of Brain Injury with Urodynamic Findings

Abstract

We evaluated the effects of an acute cerebrovascular accident on the lower urinary tract and correlated the site of cerebrovascular accident with findings on urodynamic study. A total of 45 men and 15 women underwent a complete urodynamic study with electromyography within 72 hours of a cerebrovascular accident. Patients were divided into 5 different groups based on urodynamic findings. The majority of cortical and internal capsule lesions resulted in detrusor hyperreflexia. A total of 28 patients (47%) had urinary retention, mainly due to detrusor areflexia (75%). Of 20 patients with hemorrhagic infarcts 17 (85%) had areflexia, compared to only 4 of 40 (10%) with ischemic infarcts. All 6 patients with cerebellar infarction had detrusor areflexia. Our results confirm many previously reported findings. In addition, there was a specific correlation of cerebellar and hemorrhagic infarctions with detrusor areflexia.