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  4. Editorial Comment: Prediction Model for Neurogenic Bladder Recovery One Year After Traumatic Spinal Cord Injury

Editorial Comment: Prediction Model for Neurogenic Bladder Recovery One Year After Traumatic Spinal Cord Injury

Int Braz J Urol, 2023 · DOI: 10.1590/S1677-5538.IBJU.2023.06.02 · Published: November 1, 2023

Spinal Cord InjuryUrology

Simple Explanation

El Sammak S. et al. have aimed to build a prediction model for neurogenic lower urinary tract dysfunction (NLUTD) recovery 1 year after traumatic spinal cord injury (SCI). This prediction model may ultimately help us counsel our patients through the first year of rehabilitation and provide good arguments in favor of assisted bladder emptying options. Although this prediction model provides relevant information, one should emphasize the role of invasive urodynamics to assess the risk of upper urinary tract deterioration among patients with traumatic SCI, particularly for those with suprasacral lesions.

Study Duration
From 2000 to 2016
Participants
2515 patients with NLUTD after acute SCI, of whom 417 patients (16.6%) recovered bladder function within 1 year
Evidence Level
Not specified

Key Findings

  • 1
    Sacral sensation, American Spinal Injury Association (ASIA) impairment score, bowel function at baseline, voluntary sphincter contraction, anal sensation, S1 motor scores, and the number of days in the rehabilitation facility were identified as predictors of bladder recovery, with a discriminative capacity of 90.5%.
  • 2
    Patients aged 30-44 made up the majority of the population (26.5%).
  • 3
    Most patients (79.8%) were male, and the three most frequent traumatic etiologies were violence (11.7%), falls (28.4%), and car accidents (43.3%).

Research Summary

El Sammak S. et al. have aimed to build a prediction model for neurogenic lower urinary tract dysfunction (NLUTD) recovery 1 year after traumatic spinal cord injury (SCI). This prediction model may ultimately help us counsel our patients through the first year of rehabilitation and provide good arguments in favor of assisted bladder emptying options. According to the European Association of Urology (EAU) guidelines on Neuro-Urology, urodynamic investigation should be performed as a mandatory baseline diagnostic intervention and at regular intervals in high-risk patients (1).

Practical Implications

Patient Counseling

The prediction model can aid in counseling patients about their bladder recovery trajectory after SCI.

Rehabilitation Planning

The model can promote individualized rehabilitative efforts based on predicted recovery.

Invasive Urodynamics

Emphasizes the role of invasive urodynamics to assess the risk of upper urinary tract deterioration.

Study Limitations

  • 1
    The prediction model provides relevant information, but one should emphasize the role of invasive urodynamics.
  • 2
    The model is based on data collected from 2000 to 2016, which may not reflect current practices.
  • 3
    The study focuses on recovery within the first year after SCI and may not be applicable to long-term outcomes.

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