Detrusor-Sphincter Dyssynergia and Detrusor Hyperreflexia Leading to Hydronephrosis During Intermittent Catheterization

Two cases of spinal cord injury with detrusor-sphincter dyssynergia and detrusor hyperreflexia are presented. In 1 patient bilateral hydronephrosis developed between 3 and 7 months after injury while he was on intermittent catheterization. In the other patient early sphincterotomy (3 1/2 months post-injury) was not followed by upper tract changes. Urodynamic evaluation should be done before intermittent catheterization is continued for more than 3 months after spinal cord injury. The importance of early diagnosis and appropriate management of detrusor-sphincter dyssynergia associated with detrusor hyperreflexia is discussed.