Male sex is a risk factor for detrusor pressure jeopardising the upper urinary tract in patients with spinal cord injury

Objective: To evaluate sex differences in maximum storage detrusor pressure (Pdet storage), focusing on Pdet storage ≥40 cmHO, an established risk factor for upper urinary tract damage, within the first year after spinal cord injury (SCI). Patients and methods: A cohort of patients with neurogenic lower urinary tract dysfunction due to acute traumatic or ischaemic SCI, managed according to the European Association of Urology Guidelines on Neuro-Urology, prospectively underwent urodynamic investigations at 1, 3, 6 and 12 months after SCI at a university SCI centre. Pearson's chi-squared tests and multivariable regression analyses were used to compare outcomes between females and males. Conclusions: Females rarely reached a Pdet storage ≥40 cmHO during the first year after SCI and had lower Pdet storage and DOLPP than males. However, the prevalence of urinary incontinence was similar between the sexes, suggesting the need for a more sex-tailored approach to patient management.