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Voiding Dysfunction and Upper Tract Deterioration after Spinal Cord Injury

  • Neurogenic Bladder (C Powell, Section Editor)
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Abstract

This is a review of the most current literature on the evaluation and management of the urinary system after spinal cord injury (SCI). Spinal cord injury virtually always results in some degree of neurogenic bladder (NGB) dysfunction. While it is widely accepted that NGB dysfunction is associated with an increased risk of urologic complications, consensus regarding screening for those complications, and medical or surgical management is not widely accepted. Regarding screening for complications, an annual renal ultrasound is an appropriate screening test to assess for renal pathology including stones. General guidelines for urodynamic evaluation in patients with SCI were recently published and do not explicitly recommend routine testing. Regarding NGB complications, neurogenic bladders are most prone to urinary tract infections and stones. Medical, equipment and surgical options are all aimed at decreasing the risk of these complications in SCI patients.

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Abbreviations

CIC:

clean intermittent catheterization

CKD:

chronic kidney disease

CMG:

cystometrogram

EMG:

electromyography

GFR:

glomerular filtration rate

MDRD:

modification of diet in renal disease

NGB:

neurogenic bladder

PCNL:

percutaneous nephrolithotomy

SCI:

spinal cord injury

UDS:

urodynamics

UTI:

urinary tract infection

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Conflict of Interest

S. Lenherr: none; A. Cameron: received grant from Medtronic.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Urology, Division of Neurourology and Pelvic Reconstructive Surgery, University of Michigan, 1500 E. Medical Center Drive 3875 Taubman Center, SPC 5330, Ann Arbor, MI, 48109-5330, USA

    Sara M. Lenherr & Anne P. Cameron

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  1. Sara M. Lenherr
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  2. Anne P. Cameron
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Correspondence to Sara M. Lenherr.

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Lenherr, S.M., Cameron, A.P. Voiding Dysfunction and Upper Tract Deterioration after Spinal Cord Injury. Curr Bladder Dysfunct Rep 8, 289–296 (2013). https://doi.org/10.1007/s11884-013-0200-0

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  • DOI: https://doi.org/10.1007/s11884-013-0200-0

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