Baclofen in the treatment of detrusor-sphincter dyssynergia in spinal cord injury patients.

The pharmacodynamics of baclofen on the bladder and urethral sphincters in acute and chronic spinal cord injury male patients were evaluated. A total of 100 supine and sitting urodynamic profiles was done in 25 patients. Baclofen decreased external urethral sphincter resistance by depressing pudendal-to-pudendal nerve reflex through spinal cord presynaptic hyperpolarization. This new centrally acting antispastic drug produced a significant reduction of residual urine in 73 per cent of the cases within an average of 4.98 weeks. Baclofen is a new alternative in the medical treatment of postural non-electrically induced detrusor striated sphincter dyssynergia in spinal cord injury patients. Indications for external sphincterotomy are discussed.