Influence of urinary management on urologic complications in a cohort of spinal cord injury patients.
OBJECTIVE
To study urologic complications in patients with spinal cord injury (SCI) in relation to their bladder management.


METHODS
A cohort study of patients with SCI in a rehabilitation center.


METHODS
One hundred eighty-two patients were studied; demographic data, disease characteristics, and urologic history were obtained for each.


METHODS
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
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.


CONCLUSIONS
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.
Gallien
P
P
Clinique de Rééducation Fonctionnelle, Centre Hospitalier et Universitaire de Rennes, Hôpital Pontchaillou, France.
Nicolas
B
B
Robineau
S
S
Le Bot
M P
MP
Durufle
A
A
Brissot
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002420:Cauda Equina; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008405:Massage; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods; D014563:Urodynamics; D014570:Urologic Diseases / Q000209:etiology* / Q000628:therapy*