DOI: https://doi.org/10.36347/sasjm.2025.v11i07.018

Pages: 739-743

Objectives: Differentiation of upper motor neuron lesion (UMNL) from lower motor neuron lesion (LMNL) has been proven to play an important role in decision of therapy protocol for patients with spinal cord injury (SCI). This study was to explore the capacity of sonography videourodynamic studies (SVUDS) for detecting difference between UMNL and LMNL. Methods and Patients: Clinical data of male patients with SCI and NLUTD underwent SVUDS from Oct 2020 to Oct 2024 in the Second Affiliated Hospital of Guilin Medical University were retrospectively reviewed. All patients recruited were divided into two groups, in which SCI patients with lesion above S1 were grouped into UMNL and below S1 into LMNL. Age, Parameters of SVUDS, including maximum detrusor pressure (Pdet.max), post-voiding residual (PVR), bladder outlet obstruction index (BOOI), and bladder wall thick (BWT), and incidence of detrusor sphincter dyssynergia (DSD) and flaccid bladder (FB), presenting hypotonic areflexic detrusor, were compared between UMNL and LMNL. Results: Although age, Pdet.max, BOOI, and BWT of UMNL group was not respectively statistically different from that of LMNL, significant larger PVR was found in LMNL compared to UMNL. A higher incidence of DSD and a lower prevalence of FB in male patients with UMNL were discerned compared to that of LMNL. Conclusions: Only PVR rather than age, Pdet.max, BOOI, and BWT was found to be a non-invasive parameter of SVUDS to differentiate UMNL from LMNL in this study. All DSD presented in UMNL patients and hypotonic areflexic detrusor was mostly derived from LMNL, which could be detected conveniently using SVUDS without fear of radiological risk.