Risk factors for urinary stone formation in men with spinal cord injury: a 17-year follow-up study.
OBJECTIVE
To establish hazard ratios for risk of urinary stone formation in men with chronic spinal cord injury.


METHODS
In all, 140 men injured before 1987 were eligible for this investigation and were followed yearly from January 1987 and December 2003.


RESULTS
Over the 17 years, 39 patients (28%) and 21 (15%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. In multivariate analysis, bladder stone was more common in patients injured when aged > or = 24 years than in those injured when aged <24 years (odds ratio 2.5; 95% confidence interval 1.1-5.7; P = 0.03). In another model, patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (4.1, 1.3-12.9; P = 0.016). Renal stone was more common for patients with urethral catheterization than for those voiding spontaneously (5.7, 1.3-24.6, P = 0.021) and for patients with bladder stone than for those without (4.7, 1.5-15.1; P = 0.01).


CONCLUSIONS
Injury characteristics are important for the development of urinary stone in chronic traumatic spinal cord injury. In addition, the present findings suggest that in men who cannot use intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than urethral catheterization to avoid renal stone formation.
Department of Urology, Seoul Veterans Hospital, 6-2 Doonchon-2-dong, Kangdong-gu, Seoul 134-791, Korea.
Ja Hyeon
JH
Ku
Tae Y
TY
Jung
Jeong K
JK
Lee
Won H
WH
Park
Hong B
HB
Shim
D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D001744:Urinary Bladder Calculi / Q000209:etiology*; D001750:Urinary Bladder, Neurogenic / Q000150:complications; D014546:Urinary Catheterization