Prevalence of unfavorable video-urodynamic findings and clinical implications in patients with minimally conscious state/unresponsive wakefulness syndrome: A retrospective descriptive analysis

---

Sandra Gunhild Erika Möhr
 

REHAB Basel, Switzerland

: Int J Ment Health Psychiatry

Abstract

---

The aim of this retrospective exploratory study was to investigate the prevalence of unfavorable findings during video-urodynamic studies (VUDS) in patients with minimally conscious state (MCS)/unresponsive wakefulness syndrome (UWS) and whether management of the lower urinary tract (LUT) was adjusted accordingly. A retrospective chart review was conducted to screen for patients diagnosed with MCS/UWS at our rehabilitation center between 2011 and 2020. Patients 18 years or older were included and underwent baseline VUDS after being diagnosed with MCS/UWS. We analyzed urodynamic parameters and subsequent changes in LUT management in this cohort. In total, 32 patients (7 females, 25 males, median age 37 years) with MCS/UWS were included for analysis. While at least one unfavorable VUDS finding (i.e., neurogenic detrusor overactivity [NDO], detrusor sphincter dyssynergia {DSD, high maximum detrusor pressure during storage phase [>40 cmH2O], low-compliance bladder [<20 mL/cmH2O], and vesico–uretero–renal reflux [VUR]) was found in each patient, NDO (78.1%, 25/32) and DSD (68.8%, 22/32) were the two most frequent unfavorable VUDS findings. Following baseline VUDS, new LUT treatment options were established in 56.3% (18/32) of all patients. In addition, bladder-emptying methods were changed in 46.9% (15/32) of all patients, resulting in fewer patients relying on indwelling catheters. Our retrospective exploratory study revealed a high prevalence of NDO and DSD in patients with MCS/UWS, illustrating the importance of VUDS to adapt LUT management in this cohort accordingly.

Biography

---

Sandra Gunhild Erika Möhr, born on July 3, 1974, in Berlin, Germany, holds dual citizenship in Germany and Switzerland. After completing her education at the 16th Polytechnische Oberschule Berlin-Centre and Max-Planck-Gymnasium Berlin-Centre, she graduated with a Baccalaureate. Möhr pursued her passion for medicine at Humboldt University Berlin from 1995 to 2000, obtaining a state examination/master's degree. She honed her expertise in urology during her tenure at Unfallkrankenhaus Berlin from 2001 to 2007, including a surgical year abroad. Achieving specialist recognition in 2007, she later became a Senior Physician at REHAB Basel in July 2008, serving as the Head of Urology and Radiation Protection Officer since 2011. Acknowledged for Special Neuro-Urology by SWIF in 2015, Möhr holds recognition from the SWIF training center since 2019. Actively engaged in medical societies, she is a member of the DGU, EAU, Swiss SGU, SGUM, DMGP, and SSoP, among others. Möhr actively contributes to ongoing medical studies, including TASCI and the SwISCI Cohort Study, showcasing her commitment to advancing medical knowledge..