Gallien P, Nicolas B, Robineau S, Le Bot M P, Durufle A, Brissot R
Clinique de Rééducation Fonctionnelle, Centre Hospitalier et Universitaire de Rennes, Hôpital Pontchaillou, France.
Arch Phys Med Rehabil. 1998 Oct;79(10):1206-9. doi: 10.1016/s0003-9993(98)90263-5.
To study urologic complications in patients with spinal cord injury (SCI) in relation to their bladder management.
A cohort study of patients with SCI in a rehabilitation center.
One hundred eighty-two patients were studied; demographic data, disease characteristics, and urologic history were obtained for each.
Patients responding to a questionnaire were given a clinical exam. Their medical records were reviewed, with particular attention given to the following urologic complications: lithiasis, urinary infections, orchiepididymitis, urethral trauma, vesicorenal reflux, and renal failure.
Results are reported for 123 patients. Time since SCI was 8 years. Intermittent catheterization was the main method of bladder management. Only 32 patients had changed their method of vesical voiding. Urinary complications had developed in 75% of patients. The most common complication was urinary infection. Vesicoureteral reflux occurred in 26% of patients using percussion. Trauma related to catheterization was the main problem with intermittent catheterization, responsible for a high rate of orchiepididymitis.
Intermittent catheterization is the most-used method of bladder management, but with a nonnegligible rate of urethral trauma in men. Percussion and Credé maneuver appear to be acceptable techniques of bladder management if the patient is closely monitored.
