Influence of urinary management on urologic complications in a cohort of spinal cord injury patients

• Published in: Archives of physical medicine and rehabilitation Vol. 79; no. 10; p. 1206
• Main Authors: Gallien, P, Nicolas, B, Robineau, S, Le Bot, M P, Durufle, A, Brissot, R
• Format: Journal Article
• Language: English
• Published: United States 01-10-1998
• Subjects: Adult; Aged; Aged, 80 and over; Cauda Equina; Cohort Studies; Female; Humans; Male; Massage; Middle Aged; Nerve Compression Syndromes - etiology; Nerve Compression Syndromes - therapy; Retrospective Studies; Spinal Cord Injuries - complications; Surveys and Questionnaires; Urinary Catheterization - adverse effects; Urinary Catheterization - methods; Urodynamics; Urologic Diseases - etiology; Urologic Diseases - therapy
• ISSN: 0003-9993
• DOI: 10.1016/S0003-9993(98)90263-5

To study urologic complications in patients with spinal cord injury (SCI) in relation to their bladder management.
A cohort study of patients with SCI in a rehabilitation center.
One hundred eighty-two patients were studied; demographic data, disease characteristics, and urologic history were obtained for each.
Patients responding to a questionnaire were given a clinical exam. Their medical records were reviewed, with particular attention given to the following urologic complications: lithiasis, urinary infections, orchiepididymitis, urethral trauma, vesicorenal reflux, and renal failure.
Results are reported for 123 patients. Time since SCI was 8 years. Intermittent catheterization was the main method of bladder management. Only 32 patients had changed their method of vesical voiding. Urinary complications had developed in 75% of patients. The most common complication was urinary infection. Vesicoureteral reflux occurred in 26% of patients using percussion. Trauma related to catheterization was the main problem with intermittent catheterization, responsible for a high rate of orchiepididymitis.
Intermittent catheterization is the most-used method of bladder management, but with a nonnegligible rate of urethral trauma in men. Percussion and Credé maneuver appear to be acceptable techniques of bladder management if the patient is closely monitored.