Bladder stones in patients with spinal cord injury: a long-term study.
METHODS
Retrospective follow-up study.


OBJECTIVE
To assess the occurrence of bladder stones in patients with spinal cord injury (SCI).


METHODS
Single SCI rehabilitation center in Switzerland.


METHODS
We searched our database for SCI patients who had undergone surgery due to bladder stones between 2004 and 2012. In all patients retrieved, personal characteristics, bladder management, bladder stone occurrence and time to stone formation/recurrence were recorded.


RESULTS
We identified 93 (3.3%) of 2825 patients with bladder stones, 24 women and 69 men, with a mean age 50 years (17-83) years. We observed bladder stones in patients with suprapubic catheter (SPC) in 11% (50/453), transurethral catheter (TC) in 6.6% (5/75), with intermittent catheterization (IC) in 2% (27/1315) and with reflex micturition (RM) in 1.1% (11/982), respectively. The mean time period to stone development was 95 months. The TC group had the shortest time interval (31 months), followed by the SPC group (59 months), individuals performing IC (116 months) and RM (211 months), respectively. Bladder stone recurrence rate was 23%. Recurrences were most frequent in the TC group (40%), followed by SPC (28%) and IC (22%), whereas no recurrences occurred in the RM group. Time to recurrence was shortest in the SPC group (14 months), followed by the IC (26 months) and the TC group (31 months), respectively.


CONCLUSIONS
In SCI patients, bladder management has an important role in the development of bladder stones. Indwelling catheters (TC/SPC) are associated with the highest risk to develop bladder stones and therefore should be avoided if possible. If unavoidable, SPC are superior to TC.
Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
P
P
Bartel
Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland.
J
J
Krebs
Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
J
J
Wöllner
Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
K
K
Göcking
Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
J
J
Pannek
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D001744:Urinary Bladder Calculi / Q000150:complications* / Q000453:epidemiology* / Q000601:surgery; D014546:Urinary Catheterization; D055815:Young Adult