Joshi Mrinal, Mittal Nimish
J Spinal Cord Med. 2014 May;37(3):346-8. doi: 10.1179/2045772313Y.0000000133. Epub 2013 Nov 26.
Clean intermittent catheterization has been demonstrated to be a safe and effective method of bladder drainage in patients with neurogenic bladder dysfunction. However, breakdowns in technique may allow the introduction of foreign matter into the bladder and thereby result in bladder calculi. The three cases reported herein demonstrate this potential problem in persons with spinal cord injury (SCI) with hair nidus as the source of bladder calculi causing neurogenic bladder. In each situation, the problem was identified, calculi were removed cystoscopically and the patient and/or the ancillary aid were reinstructed. We recommend annual renal function tests, ultrasound and cytoscopic screening in high suspicion cases to allow early detection of bladder calculi in persons with SCI and prevent further urinary tract infections. This report also emphasizes the need for patient education and a careful follow-up preventing bladder calculi and thus, minimizing the morbidity in persons with SCI.
清洁间歇性导尿已被证明是神经源性膀胱功能障碍患者膀胱引流的一种安全有效的方法。然而,技术失误可能会使异物进入膀胱,从而导致膀胱结石。本文报告的三例病例表明,在脊髓损伤(SCI)患者中存在这一潜在问题,毛发结石是导致神经源性膀胱的膀胱结石来源。在每种情况下,问题都得到了识别,通过膀胱镜取出了结石,并对患者和/或辅助器具进行了重新指导。我们建议对高度怀疑的病例进行年度肾功能检查、超声和膀胱镜筛查,以便早期发现SCI患者的膀胱结石并预防进一步的尿路感染。本报告还强调了患者教育和仔细随访以预防膀胱结石的必要性,从而将SCI患者的发病率降至最低。