Adriaansen Jacinthe J E, van Asbeck Floris W A, Bongers-Janssen Helma M H, Spijkerman Dorien, Visser-Meily Johanna M A, de Kort Laetitia M O, Post Marcel W M
Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Spinal Cord Injury Department, Rehabilitation Center Sint Maartenskliniek, Nijmegen, the Netherlands.
Top Spinal Cord Inj Rehabil. 2017 Winter;23(1):78-87. doi: 10.1310/sci2301-78.
Individuals with spinal cord injury (SCI) have an increased risk of developing urological complications. Therefore, long-term routine urological surveillance is recommended. To describe urological surveillance in individuals with long-term SCI and to determine factors associated with urologic ultrasonography (UU) outcome. Wheelchair-dependent individuals with an SCI for 10 years or more were included. A medical assessment was done in 8 participating rehabilitation centers. The International Lower Urinary Tract Function Basic SCI Data Set was used to assess bladder-emptying methods and previous surgical procedures on the urinary tract. We studied urological surveillance: whether participants had routine urological checkups (including UU) and when latest urodynamic study was performed. Latest UU (performed <1 year ago) was retrieved or, when lacking, UU was performed as part of our study. Median time since injury (TSI) was 22.0 years. Overall, 39% of the 282 participants did not have routine urological checkups and 33% never had a urodynamic study performed. UU data ( = 243) revealed dilatation of the upper urinary tract (UUT) in 4.5% of the participants and urinary stones in 5.7%. Abnormal UU outcome was associated with increasing TSI, nontraumatic SCI, and previous surgical bladder or UUT stone removal. UU outcome was not associated with routine urological checkups or type of bladder-emptying method. Over one-third of Dutch individuals with long-term SCI did not receive routine urological surveillance. UU outcome was not associated with routine urological checkups or type of bladder-emptying method. Further research on the indication and frequency of urological surveillance is recommended.
脊髓损伤（SCI）患者发生泌尿系统并发症的风险增加。因此，建议进行长期常规泌尿系统监测。描述长期脊髓损伤患者的泌尿系统监测情况，并确定与泌尿系统超声检查（UU）结果相关的因素。纳入了依赖轮椅且脊髓损伤10年或更长时间的个体。在8个参与研究的康复中心进行了医学评估。使用国际下尿路功能基本脊髓损伤数据集评估膀胱排空方法和既往泌尿系统手术。我们研究了泌尿系统监测情况：参与者是否进行了常规泌尿系统检查（包括UU）以及最近一次尿动力学检查的时间。检索最近一次UU（在1年内进行），如果没有，则将UU作为我们研究的一部分进行。自受伤以来的中位时间（TSI）为22.0年。总体而言，282名参与者中有39%没有进行常规泌尿系统检查，33%从未进行过尿动力学检查。UU数据（n = 243）显示，4.5%的参与者存在上尿路（UUT）扩张，5.7%存在尿路结石。UU异常结果与TSI增加、非创伤性脊髓损伤以及既往膀胱或UUT结石手术切除有关。UU结果与常规泌尿系统检查或膀胱排空方法类型无关。超过三分之一的荷兰长期脊髓损伤患者未接受常规泌尿系统监测。UU结果与常规泌尿系统检查或膀胱排空方法类型无关。建议对泌尿系统监测的指征和频率进行进一步研究。
