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  4. Management of neurogenic bladder in patients with spinal cord injuries/disorders and end stage renal disease: a case series

Management of neurogenic bladder in patients with spinal cord injuries/disorders and end stage renal disease: a case series

Spinal Cord Series and Cases, 2024 · DOI: https://doi.org/10.1038/s41394-024-00623-8 · Published: February 27, 2024

Spinal Cord InjuryUrology

Simple Explanation

Patients with spinal cord injuries often experience bladder dysfunction, called neurogenic bladder. This can lead to complications like infections and kidney stones. The study focuses on patients with both neurogenic bladder from spinal cord injuries and end-stage renal disease, a complex and understudied group. The authors present eleven cases and discuss bladder management strategies using commonly available interventions.

Study Duration
10 years
Participants
Eleven veterans with SCI/D, NLUTD, and ESRD
Evidence Level
Case Series

Key Findings

  • 1
    Determining a patient's baseline urine production is crucial, especially in those with ESRD, to avoid complications from assuming anuria.
  • 2
    Inadequate bladder management in SCI/D patients with ESRD may increase morbidity and mortality.
  • 3
    The survival rate for SCI/D patients with ESRD is lower than the general population of ESRD patients.

Research Summary

This case series presents eleven unique cases of neurogenic lower urinary tract dysfunction (NLUTD) with associated end-stage renal disease (ESRD) in patients with spinal cord injuries/disorders (SCI/D). The study highlights the lack of standardized guidance for bladder management in this complex patient population and offers experiences for consideration. The authors emphasize the importance of future large-scale studies to develop a standardized protocol or algorithm for bladder management in this cohort.

Practical Implications

Clinical Management

Highlights the need for individualized bladder management strategies in SCI/D patients with ESRD, considering urine production and potential complications.

Research

Advocates for larger studies and registries to develop standardized bladder management protocols for this complex patient population.

Future Guidelines

Suggests that the findings contribute to the development of uniform guidelines for managing NLUTD in patients with SCI/D and ESRD.

Study Limitations

  • 1
    Small sample size limits the generalizability of the findings.
  • 2
    Retrospective data collection may introduce bias.
  • 3
    Lack of standardized protocols makes comparisons difficult.

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