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  4. An unresolved relationship: the relationship between lesion severity and neurogenic bladder in patients with spinal cord injury

An unresolved relationship: the relationship between lesion severity and neurogenic bladder in patients with spinal cord injury

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772315Y.0000000011 · Published: January 1, 2016

Spinal Cord InjuryUrology

Simple Explanation

This study investigates the connection between the seriousness of spinal cord injuries (SCI) and bladder issues, focusing on urodynamic findings, methods of bladder drainage, and kidney stone occurrence. The researchers assessed the link between the severity of the spinal lesion and detrusor hyperactivity/compliance, the bladder drainage method at discharge, and the presence of renal calculi. They found that while lesion severity didn't affect detrusor activity or compliance, it did influence the bladder drainage method used upon discharge from the hospital.

Study Duration
January 2007 and October 2013
Participants
131 patients with SCI
Evidence Level
Retrospective study

Key Findings

  • 1
    Detrusor hyperactivity and compliance were not related to the severity of the spinal cord lesion.
  • 2
    Bladder filling sensation differed based on the severity of the injury; preserved sensation was only found in patients with incomplete injuries.
  • 3
    The bladder drainage method at discharge varied with lesion severity; indwelling catheters were more common in complete injuries, while CIC was more frequent in incomplete injuries.

Research Summary

This study aimed to evaluate the relationship between the severity of spinal cord injury (SCI) and neurogenic bladder characteristics, renal calculi, and bladder drainage methods at discharge. The researchers found no relationship between lesion severity and detrusor hyperactivity or compliance. However, bladder filling sensation and the bladder drainage method at discharge did show a difference based on the severity of the injury. The study concludes that both complete and incomplete SCI patients should be monitored with equal diligence for neurogenic bladder dysfunction, and that patients with complete SCI should be further encouraged to employ CIC applications.

Practical Implications

Urodynamic Examination

Urodynamic examination is required in each patient with SCI.

Monitoring Sensitivity

Patients with complete and incomplete injuries should be monitored with the same sensitivity in terms of complications.

Bladder Drainage

Patients with complete SCI should be further encouraged to employ CIC applications such as bladder drainage.

Study Limitations

  • 1
    Retrospective data collection from patient charts.
  • 2
    Short follow-up periods due to rapid patient turnover.
  • 3
    Lack of prospective data.

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