title: Lower urinary tract dysfunction in ambulatory patients with incomplete spinal cord injury.
abstract: OBJECTIVE
  We evaluated urinary tract dysfunction in individuals with spinal injury who remained able to ambulate. We observed changes with time in urological management.
  
  
  METHODS
  All patients attending outpatient clinics with traumatic, incomplete (American Spinal Injury Association grades D and E) spinal cord injury during a 2-year period were identified. All patients had their hospital notes reviewed retrospectively and salient urological data extracted.
  
  
  RESULTS
  A total of 43 men and 21 women were identified during this period. Mean age was 46 years (range 18 to 70). Mean followup was 7 years (range 1 to 18). At the time of inpatient discharge 40 of the 64 patients (62.5%) could void spontaneously, 20 required CSIC and 4 had a suprapubic catheter. In 19 of these 40 patients (47.5%) who had been initially assessed as having a bladder that was safe to void spontaneously the condition deteriorated, such that CSIC was required. Conversely 5 of 20 patients (25%) who initially required CSIC improved, such that it became redundant. At last followup 68.7% of the patients had abnormal urodynamics and 24 of the 64 (37.5%) required a change in urological management despite no appreciably detectable neurological change.
  
  
  CONCLUSIONS
  Despite relatively near total neurological recovery patients with incomplete SCI have neuropathic bladder unless proved otherwise. Salient deterioration in bladder dysfunction is not uncommon. Regular urological monitoring and appropriate treatment changes are required in the long term.
authors.affiliation: Spinal Injuries Unit, Department of Neuro-urology, Royal National Orthopaedic Hospital, Stanmore, United Kingdom. prasadpatki@hotmail.com
authors.forename: Prasad
authors.initials: P
authors.lastname: Patki
authors.forename: Joe
authors.initials: J
authors.lastname: Woodhouse
authors.forename: Rizwan
authors.initials: R
authors.lastname: Hamid
authors.forename: Julian
authors.initials: J
authors.lastname: Shah
authors.forename: Michael
authors.initials: M
authors.lastname: Craggs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology* / Q000503:physiopathology