Practice patterns of Japanese physicians in urologic surveillance and management of spinal cord injury patients.
METHODS
Analysis of answers to a new questionnaire.


OBJECTIVE
To examine current practice patterns of physicians in the urological surveillance and management of spinal cord injury (SCI) patients in Japan.


METHODS
Nationwide questionnaire survey to physicians in Japan.


METHODS
A Japanese version of the 14-item questionnaire survey carried out in US was mailed to 770 members of the Japanese Neurogenic Bladder Society (JNBS).


RESULTS
We received answers to our questionnaire from 333 (43.2%) members of JNBS. The responders were all urologists. For surveillance of the upper urinary tract (UUT), 239 (71.8%) respondents preferred abdominal ultrasound. Cystometry was performed routinely by 174 (52.3%) respondents for the evaluation of vesicourethral function. Cystoscopy was carried out in cases of hematuria (88.0%) and bladder stone (55.3%). Surveillance of the urinary tract was performed every year in 154 (46.2%). For detection of bladder cancer, which 119 (37.9%) respondents have experienced, 94.9% physicians perform cystoscopy, 76.3% urinary cytology, and 60.4% ultrasound. For initial treatment of detrusor-sphincter dyssynergia (DSD), 225 (69.2%) respondents chose alpha-blocker, and 94 (28.9%) chose clean intermittent catheterization (CIC) with/without anticholinergic agent(s). For initial treatment of overactive bladder, 245 (74.7%) chose anticholinergic agent(s) only and 63 (19.2%) chose anticholinergic agent(s) with CIC. For initial treatment of areflexic bladder, 233 (73.7%) chose CIC and 63 (19.9%) chose Credé maneuver or tapping.


CONCLUSIONS
This survey shows that there are some differences in urological surveillance and management of SCI patients between Japan and the US. Reasons for the discrepancy should be examined.
Kitahara
S
S
Department of Urology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigata, Japan.
Iwatsubo
E
E
Yasuda
K
K
Ushiyama
T
T
Nakai
H
H
Suzuki
T
T
Yamashita
T
T
Sato
R
R
Kihara
T
T
Yamanishi
T
T
Nohara
Y
Y
D015897:Comorbidity; D019538:Health Care Surveys; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D014570:Urologic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*