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RS 17 Cystometrogram, Atonic Bladder and Automatic Bladder - Coggle…

- - - - The bladder is filled with 50 ml increments of
        water and at each volume, the intravesical
        pressure is recorded.
- - - - It is the initial phase of filling in which pressure rises from 0 to 10 cm of H2O, when about 50 ml of fluid is collected in the bladder.
      - Phase Ib.
        
        It is the phase of plateau which lasts till the bladder volume is 400 ml. During this phase, the pressure in the bladder does not change
        much and remains approximately at 10 cm H2O. This is because of
        adaptation of urinary bladder by relaxation, as described above.
        
        Phase II.
        
        This phase starts beyond 400 ml volume when the pressure begins to rise markedly, triggering the micturition reflex.
        Normally, the
        voiding contraction raises the intravesical pressure by about 20–40 cm of H2O. If voiding is avoided (not initiated), the pressure rises from 10 cm of H2O onward, as shown by dotted lines beyond the phase II in figure. Beyond 600 ml, the urge to void urine becomes almost unbearable.
- - - - It frequently causes constrictive fibrosis around the dorsal
        nerve root fibres where they enter the spinal cord and subsequently
        destroy these fibres.
    - - It damages the sensory roots.
- - - - The voiding reflex returns, although there is no voluntary control.
      - Some paraplegic patients train themselves to initiate voiding by pinching or stroking their thighs, provoking a mild mass reflex.