Rabadi M H, Aston C
Department of Neurology at Oklahoma University and Oklahoma City Veterans Affairs Medical Center, Oklahoma City, OK, USA.
Department of Pediatrics, Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Spinal Cord. 2015 Mar;53(3):200-203. doi: 10.1038/sc.2014.205. Epub 2014 Nov 18.
This observational study aimed to determine the types of urological lesion encountered in veterans with traumatic spinal cord injury (SCI) with neurogenic bladder (NGB), and the usage of bladder management programs to deal with NGB.
NGB (detrusor muscle and urethral sphincter dysfunction with loss of bladder sensation to void) is common in daily practice; however, information on types of urological lesions encountered in these veterans with NGB and how best to manage their NGB is limited.
We retrospectively reviewed the electronic charts of veterans with SCI enrolled in our program and regularly followed in our SCI clinic. Demographic data collected included: age, gender, ethnicity and age, level, severity and cause of spinal injury. Also noted was presence of NGB, episodes of urinary tract infection (UTI), bladder program followed and urological lesions found on renal nuclear scans, renal ultrasounds and cystoscopies.
Of the 161 veterans with SCI, symptoms of NGB was present in 133 (82.6%). Veterans with NGB had more severe spinal injury and more frequent UTI (P<0.05). Renal atrophy and hydronephrosis were the most common urological lesions seen in patients with UTI. Clean intermittent catheterization (CIC) was the most frequently used bladder program resulting in less frequent occurrence of UTI.
Renal atrophy and hydronephrosis were the most common urological lesions encountered in veterans with NGB especially in those with UTI. CIC was the most frequently used bladder management program with the least risk for UTI.
本观察性研究旨在确定创伤性脊髓损伤（SCI）合并神经源性膀胱（NGB）的退伍军人中所遇到的泌尿系统病变类型，以及膀胱管理方案在处理NGB方面的应用情况。
NGB（逼尿肌和尿道括约肌功能障碍伴膀胱排尿感觉丧失）在日常临床实践中很常见；然而，关于这些患有NGB的退伍军人所遇到的泌尿系统病变类型以及如何最佳管理其NGB的信息有限。
我们回顾性分析了纳入我们项目并在我们的SCI诊所定期随访的SCI退伍军人的电子病历。收集的人口统计学数据包括：年龄、性别、种族以及脊髓损伤的年龄、节段、严重程度和病因。还记录了NGB的存在情况、尿路感染（UTI）发作次数、所采用的膀胱管理方案以及在肾核素扫描、肾脏超声和膀胱镜检查中发现的泌尿系统病变。
在161名SCI退伍军人中，133名（82.6%）存在NGB症状。患有NGB的退伍军人脊髓损伤更严重，UTI更频繁（P<0.05）。肾萎缩和肾积水是UTI患者中最常见的泌尿系统病变。清洁间歇性导尿（CIC）是最常用的膀胱管理方案，导致UTI发生频率较低。
肾萎缩和肾积水是患有NGB的退伍军人中最常见的泌尿系统病变，尤其是在那些患有UTI的患者中。CIC是最常用的膀胱管理方案，UTI风险最低。
