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

Abstract

Objectives: We aimed to investigate the relationship between the severity of the spinal lesion and urodynamic findings, bladder drainage method at discharge, and incidence of renal calculi in patients with spinal cord injury (SCI).

Studydesign: Retrospective.

Setting: In-patient rehabilitation unit of a tertiary research hospital.

Methods: A total of 131 patients who were admitted to our clinic with a diagnosis of SCI and placed into a rehabilitation program were included in the study. The severity of the lesion was determined according to the American Spinal Injury Association Impairment Scale (AIS). We evaluated the relationship between the severity of the lesion and the detrusor hyperactivity and compliance as determined by urodynamic investigation, the bladder drainage method used at discharge, and the renal calculi rate as determined by ultrasonography.

Results: While no difference was found between the patients with complete and incomplete injuries in terms of age, sex, disease duration, detrusor hyperactivity and compliance, the bladder drainage method was found to show a significant change according to the severity of the lesion. None of the patients were found to have hydronephrosis and the rate of renal calculi showed no statistically significant difference according to the severity of the lesion.

Conclusions: We concluded that urodynamic examination is required in each patient with SCI as the severity of the lesion is not sufficient to determine the bladder type, and patients with complete and incomplete injuries should be monitored with the same sensitivity in terms of complications.

Keywords:

• Bladder management
• Neurogenic bladder
• Urodynamic examination
• Spinal cord injury

Disclaimer statements

Contributors SIA: collated and analysed the patients data and conceived the project. BS: reviewed the cases selected for inclusion and helped compile the manuscript. SAY: reviewed included cases. SNSC: helped compile the manuscript.

Funding None.

Conflicts of interest All authors have read and approved the manuscript and we have no potential conflict of interest regarding this manuscript.

Ethics approval This study was approved by Baskent University Institutional Rewiew Board (Project no: KA12/265).