Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a prospective study.
METHODS
A prospective study.


OBJECTIVE
To investigate the risk factors predicting upper urinary tract (UUT) deterioration in patients with spinal cord injury (SCI).


METHODS
Beijing, China.


METHODS
We reviewed the medical records and UUT imaging studies of 112 patients, with a mean follow-up of 2 years. Variables evaluated for possible influence on UUTs included patient age, gender and educational background; injury level and completeness; bladder management method; and the presence of adverse outcomes such as recurrent urinary tract infections and bladder stones. Video urodynamic data were also reviewed. Total renal function was assessed by serum creatinine. UUT abnormalities were assessed by renal ultrasound or magnetic resonance imaging.


RESULTS
Lumbosacral spinal cord lesions likely contribute to UUT deterioration. UUT abnormalities were present in 23 patients (65.7%) in a spontaneous voiding group, 10 patients (20%) in a clean intermittent catheterization group, 15 patients (78.9%) in an indwelling urethral catheterization group and 7 patients (87.5%) in a suprapubic Foley catheterization group (P<0.001). When dividing bladder management method into two groups, catheter-free (spontaneous and intermittent voiding) and indwelling catheter (urethral and suprapubic catheterization), there was UUT dysfunction in 33 patients (38.3%) and 22 patients (81.5%), respectively (P<0.001).


CONCLUSIONS
Lumbosacral SCI and chronic indwelling urethral and suprapubic catheterization were predictors of UUT deterioration.
1] Department of Urology, China Rehabilitation Research Center, Beijing, China [2] School of Rehabilitation Medicine, Capital Medical University, Beijing, China [3] Department of Rehabilitation Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Z
Z
Zhang
1] Department of Urology, China Rehabilitation Research Center, Beijing, China [2] School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
L
L
Liao
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012447:Sacrum; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D014463:Ultrasonography; D014551:Urinary Tract / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014563:Urodynamics; D014570:Urologic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult
D003404:Creatinine