title: Neurogenic bladder in patients with traumatic spinal cord injury: treatment and follow-up.
abstract: METHODS
  Multi-center, cross-sectional study.
  
  
  OBJECTIVE
  Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire.
  
  
  METHODS
  Turkey.
  
  
  METHODS
  Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management.
  
  
  RESULTS
  The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization (IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation (P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders (P>0.05). The most common anticholinergic drug used was oxybutynin (40.3%), followed by trospium (32.6%), tolterodine (19.3%) darifenacin (3.3%), propiverine (3.3%) and solifenacin (1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists (76.2%), urologists (22.1%) and neurologists (1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients (77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital (15.3%) and monetary problems (7.7%). Of the patients, 42.7% did not experience urinary tract infections (UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had ⩾3 clinical UTIs. The clinical characteristics of patients with and without UTI (at least one symptomatic UTI during 1 year) were similar (P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques (P>0.05).
  
  
  CONCLUSIONS
  The most frequently used technique for bladder rehabilitation in patients with SCI was IC (77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Yıldız
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Akkoç
authors.affiliation: Istanbul Physical Medicine Rehabilitation Training Hospital, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Erhan
authors.affiliation: Istanbul Physical Medicine Rehabilitation Training Hospital, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Gündüz
authors.affiliation: Gülhane Military Medical Academy Turkish Armed Forces Rehabilitation and Care Center, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Yılmaz
authors.affiliation: Gülhane Military Medical Academy Turkish Armed Forces Rehabilitation and Care Center, Ankara, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Alaca
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Gök
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health, Ankara, Turkey.
authors.forename: K
authors.initials: K
authors.lastname: Köklü
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ersöz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Cınar
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Karapolat
authors.affiliation: Department of Physical Medicine and Rehabilitation, Pamukkale University Faculty of Medicine, Denizli, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Catalbaş
authors.affiliation: Istanbul Physical Medicine Rehabilitation Training Hospital, Istanbul, Turkey.
authors.forename: A N
authors.initials: AN
authors.lastname: Bardak
authors.affiliation: Istanbul Physical Medicine Rehabilitation Training Hospital, Istanbul, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Turna
authors.affiliation: Gülhane Military Medical Academy Turkish Armed Forces Rehabilitation and Care Center, Ankara, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Demir
authors.affiliation: Department of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Güneş
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Alemdaroğlu
authors.affiliation: Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Tunç
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057928:Intermittent Urethral Catheterization; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000188:drug therapy / Q000503:physiopathology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy / Q000503:physiopathology* / Q000534:rehabilitation*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000503:physiopathology; D055815:Young Adult
chemical_list: D018680:Cholinergic Antagonists