Header

UZH-Logo

Maintenance Infos

Neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury: long-term urodynamic findings


Schöps, Tim-Friedjof; Schneider, Marc P; Steffen, Frank; Ineichen, Benjamin V; Mehnert, Ulrich; Kessler, Thomas M (2015). Neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury: long-term urodynamic findings. BJU International, 115 Supp:33-38.

Abstract

OBJECTIVES: To investigate long-term urodynamic findings in patients with spinal cord injury (SCI) with neurogenic lower urinary tract dysfunction (NLUTD).
PATIENTS AND METHODS: A consecutive series of 246 patients with SCI (≥5 years since injury) and NLUTD were prospectively evaluated at a single university SCI centre. Data of the latest and earliest available urodynamic investigation were compared.
RESULTS: Most of the patients had a thoracic SCI and American Spinal Injury Association (ASIA) impairment scale of A. The mean (sd) duration of SCI to the latest available urodynamic investigation was 17 (10) years and the mean patient age was 51 (14) years. At the earliest and latest available urodynamic investigation, more than half of the patients relied on intermittent self-catheterisation. During the course of disease, there was a relevant increase of patients undergoing onabotulinumtoxinA injections into the detrusor from 12% to 33%. Urodynamic findings at the earliest and latest available urodynamic investigation were within the safe limits and there were significant differences between both groups for maximum cystometric capacity (P < 0.001), compliance (P < 0.001) and maximum detrusor pressure during storage phase (P = 0.008). Vesico-uretero-renal reflux was detected in ≈5% and it was generally low grade.
CONCLUSIONS: Most of our regularly followed patients with NLUTD due to SCI for a mean of 17 years had urodynamic findings within the safe limits. Vesico-uretero-renal reflux was quite rare and generally low grade. Thus, regular follow-up with urodynamic investigation allowing for a patient-tailored management seems beneficial warranting randomised controlled longitudinal studies.

Abstract

OBJECTIVES: To investigate long-term urodynamic findings in patients with spinal cord injury (SCI) with neurogenic lower urinary tract dysfunction (NLUTD).
PATIENTS AND METHODS: A consecutive series of 246 patients with SCI (≥5 years since injury) and NLUTD were prospectively evaluated at a single university SCI centre. Data of the latest and earliest available urodynamic investigation were compared.
RESULTS: Most of the patients had a thoracic SCI and American Spinal Injury Association (ASIA) impairment scale of A. The mean (sd) duration of SCI to the latest available urodynamic investigation was 17 (10) years and the mean patient age was 51 (14) years. At the earliest and latest available urodynamic investigation, more than half of the patients relied on intermittent self-catheterisation. During the course of disease, there was a relevant increase of patients undergoing onabotulinumtoxinA injections into the detrusor from 12% to 33%. Urodynamic findings at the earliest and latest available urodynamic investigation were within the safe limits and there were significant differences between both groups for maximum cystometric capacity (P < 0.001), compliance (P < 0.001) and maximum detrusor pressure during storage phase (P = 0.008). Vesico-uretero-renal reflux was detected in ≈5% and it was generally low grade.
CONCLUSIONS: Most of our regularly followed patients with NLUTD due to SCI for a mean of 17 years had urodynamic findings within the safe limits. Vesico-uretero-renal reflux was quite rare and generally low grade. Thus, regular follow-up with urodynamic investigation allowing for a patient-tailored management seems beneficial warranting randomised controlled longitudinal studies.

Statistics

Citations

9 citations in Web of Science®
9 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:April 2015
Deposited On:25 Nov 2015 09:14
Last Modified:05 Apr 2016 19:32
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1464-4096
Publisher DOI:https://doi.org/10.1111/bju.13085
PubMed ID:25891318

Download

Full text not available from this repository.
View at publisher