title: Long-term urological outcomes in paediatric spinal cord injury.
abstract: METHODS
  Retrospective review.
  
  
  OBJECTIVE
  This retrospective review observes the evolution of bladder management by time and reports adult urological outcomes and complications in paediatric onset spinal cord injury (SCI).
  
  
  METHODS
  Spinal Injuries Unit RNOH Stanmore.
  
  
  METHODS
  In total, 10 traumatic SCI patients with mean age at injury of 13.6 years underwent treatment, for a mean period of 13.1 years. Characteristics of injury were noted. Two diagnostic subgroups, neurogenic detrusor overactivity (NDO), and acontractile detrusor were made. Complications, treatment changes, operative procedures with follow-up were noted.
  
  
  RESULTS
  In group 1 (6/10 patients) with NDO, five had DSD. Initial bladder management was reflex/urge voiding (n=4), suprapubic catheterisation (SPC), (n=1) and self-intermittent catheterisation (SIC), (n=1). Two patients had multiple upper tract complications with decreased renal function, two recurrent symptomatic urinary infections and one; bladder calculus. In total, 12 operative procedures were performed to treat complications and change bladder management to, SIC+oxybutynin (n=3), ileal conduit (n=1), sacral anterior root stimulator implant (SARSI), (n=1), voiding on urge (n=1). In group 2 (4/10 patients) with a-contractile detrusor two had low compliance. Initial bladder management was SIC (n=3) and voiding on urge/straining (n=1). Two patients converted from SIC to permanent catheter drainage and reported complications. Incidental kidney stone was diagnosed in one. A total of four interventions were carried out with final management of SIC (n=2), voiding on urge/straining (n=1) and Mitrofanoff+ileocystoplasty (n=1).
  
  
  CONCLUSIONS
  Bladder management in paediatric SCI is dependent on neurological level and type of injury; it changes with growth and is affected by changes in bladder management.
authors.affiliation: 1Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
authors.forename: P
authors.initials: P
authors.lastname: Patki
authors.forename: R
authors.initials: R
authors.lastname: Hamid
authors.forename: S
authors.initials: S
authors.lastname: Somayaji
authors.forename: J
authors.initials: J
authors.lastname: Bycroft
authors.forename: P J R
authors.initials: PJ
authors.lastname: Shah
authors.forename: M
authors.initials: M
authors.lastname: Craggs
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014546:Urinary Catheterization; D014563:Urodynamics