Seoane-Rodriguez et al. 2007; Spain
Downs & Black =18
Case series
N=47

Population: 47 males; 32 subjects with cervical, 11 with thoracic, and 4 with lumbar injuries;  mean post-injury time to stenting was 103.8 months. Mean follow-up time from implantation 67 months. Type of injury: 36 AIS A; 4 AIS B and 7 AIS C.
Treatment: intraurethral stent
Outcome Measures: Urodynamic parameters; presence or absence of symptomatic UTI; autonomic dysreflexia; appearance of complications of the upper urinary tract (UUT); bladder management before and after surgery; prosthesis complications

• Decrease in symptomatic UTI by 25%.
• Decrease in post void residual urine volume by an average of 224.3 cm3
• Episodes of dysreflexia decreased from 35.1% to 16.2%.
• Complications in the UUT decreased from 46.8 to 23.4%.
• Urodynamic study showed an average reduction of 44.4 cm3 H2O in the maximum detrusor pressure.
• Most frequent stent complication was displacement, followed by stenosis, lithiasis (pathological formation of mineral concentrations in the body), and intraprosthetic calcification. 8.5% required stent removal.

Perkash 2007; USA
Downs & Black = 17
Case series
N=46

Population: 46 males; 31 subjects with tetraplegia and 15 with paraplegia; Type of injury: 43 AIS A and B, 3 AIS C.
Treatment: Transurethral sphincterotomy (TURS)
Outcome Measures: Autonomic dysreflexia during cystometrogram (measures the contractile force of the bladder when voiding), blood pressure

• During cystometrogram, mean maximal systolic pressure was 160±23 pre and 108±17 mmHg post. Mean diastolic pressure was 88±15 pre and 62±11 mmHg post (p<0.0001).
• Mean decrease in systolic BP and diastolic BP after TURS was 55±26 and 30±17mmHG, respectively.
• Amelioration in symptoms of AD.
• Mean post-void residual urine decreased significantly from 233±152 to 137±0.35 mL after TURS.
• 4 patients still exhibited AD within 1 year of laser TURS.

Barton et al. 1986; USA
Downs & Black = 12
Case Series
N=16

Population: 5 subjects with thoracic, and 8 with cervical injuries, 47-285 months post-injury.
Treatment: modified transurethral external sphincterotomy with follow-up to 26 wks.
Outcome Measures: bladder and urethral pressures and volumes, blood pressures

• ↓intravesical and urethral pressures compared to before sphincterotomy (p<.001)
• ↓ blood pressure responses during urodynamic stimulation (p<.01).
• Other cardiovascular responses related to AD during bladder filling markedly attenuated.

Sidi et al. 1990; USA
Downs & Black = 11
Pre-post
N=12

Population: 9 subjects with complete SCI, 3 with incomplete injuries; Level of Injury: C5-T11; 2-27 years post-injury
Treatment: augmentation enterocystoplasty
Outcome Measures: functional bladder capacity, levels of blood urea nitrogen, creatinine, electrolytes

• By 4 months post-op, 11/12 patients were totally continent on clean intermittent self-catheterization every 4-6 hours. 
• Of the 3 patients who had an artificial urinary sphincter, 2 became continent after sphincter activation and 1 had achieved continence without sphincter activation. No patients experienced symptoms of AD during intermittent catheterization post-operatively.