Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur Malaysia.
Department of Rehabilitation Medicine, Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi.
J Pak Med Assoc. 2023 Oct;73(10):2123-2125. doi: 10.47391/JPMA.23-77.
Neurogenic bladder is one of the negative consequences following a spinal cord injury (SCI). SCI patients who have neurogenic bladder depend on alternative methods to drain urine from their bladder. These include indwelling catheters, reflex voiding , suprapubic tapping and intermittent catheterisation. This review summarizes evidence from the literature of five selected complications (renal failure, urinary tract infections, calculi, urethral stricture, and bladder cancer) that could result from use of the different bladder drainage methods. There is inconsistent evidence to support the superiority of intermittent over indwelling catheterisation on risk of renal impairment, urethral stricture, and renal calculi. Indwelling catheterisations are associated with higher risk of bladder calculi and cancer. Caution needs to be taken when interpreting this review, as many of its findings are from retrospective studies, and more than a decade old. Clinicians need to communicate the evidence to their patients when making the decision on method of bladder drainage.
神经原性膀胱是脊髓损伤(SCI)后的负面后果之一。患有神经原性膀胱的 SCI 患者依赖于替代方法从膀胱中排出尿液。这些方法包括留置导尿管、反射性排尿、耻骨上穿刺和间歇性导尿。本综述总结了文献中关于五种不同膀胱引流方法可能导致的五种并发症(肾衰竭、尿路感染、结石、尿道狭窄和膀胱癌)的证据。有不一致的证据表明,间歇性导尿在肾功能损害、尿道狭窄和肾结石风险方面优于留置导尿。留置导尿管与膀胱结石和癌症的风险更高有关。在解释本综述时需要谨慎,因为其许多发现来自回顾性研究,且研究时间超过 10 年。临床医生在决定膀胱引流方法时需要将证据告知患者。