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.
Clinique de Rééducation Fonctionnelle, Centre Hospitalier et Universitaire de Rennes, Hôpital Pontchaillou, France.
P
P
Gallien
B
B
Nicolas
S
S
Robineau
M P
MP
Le Bot
A
A
Durufle
R
R
Brissot
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*