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Surveillance and management of urologic complications after spinal cord injury

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Abstract

Purpose

Neurogenic bladder due to spinal cord injury has significant consequences for patients’ health and quality of life. Regular surveillance is required to assess the status of the upper and lower urinary lower urinary tracts and prevent their deterioration. In this review, we examine surveillance techniques in neurogenic bladder, describe common complications of this disease, and address strategies for their management.

Methods

This work represents the efforts of SIU-ICUD joint consultation on Urologic Management of the Spinal Cord injury. For this specific topic, a workgroup was formed and comprehensive literature search of English language manuscripts regarding neurogenic bladder management was performed using key words of neurogenic bladder. Articles were compiled, and recommendations in the chapter are based on group discussion and follow the Oxford Centre for Evidence-based Medicine system for Levels of Evidence (LOEs) and Grades of Recommendation (GORs).

Results

At a minimum, patients should undergo an annual history and physical examination, renal functional testing (e.g., serum creatinine), and upper tract imaging (e.g., renal ultrasonography). The existing evidence does not support the use of other modalities, such as cystoscopy or urodynamics, for routine surveillance. Urologic complications in neurogenic bladder patients are common and often more complex than in the general population.

Conclusions

There is a shortage of high-quality evidence to support any particular neurogenic bladder surveillance protocol. However, there is consensus regarding certain aspects of regular genitourinary system evaluation in these patients. Proper surveillance allows the clinician to avoid or address common urological complications, and to guide, alter, or maintain appropriate therapeutic regimens for individual patients.

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Authors and Affiliations

  1. USC Institute of Urology, 1441 Eastlake Avenue, suite 7414, Los Angeles, CA, 90033, USA

    Evgeniy Kreydin & David A. Ginsberg

  2. Division of Urology, The University of Western Ontario, London, ON, Canada

    Blayne Welk

  3. Columbia University College of Physicians and Surgeons, New York, NY, USA

    Doreen Chung

  4. University of Michigan, Ann Arbor, MI, USA

    Quentin Clemens

  5. University of Washington, Seattle, WA, USA

    Claire Yang

  6. Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA

    Teresa Danforth

  7. Bladder Health and Reconstructive Urology Institute, Miami, FL, USA

    Angelo Gousse & Nicole Szell

  8. Northwestern Fienberg School of Medicine, Chicago, IL, USA

    Stephanie Kielb

  9. University of Texas, San Antonio, San Antonio, TX, USA

    Stephen Kraus

  10. Department of Urology, Pitié-Salpêtrière, Paris, France

    Altaf Mangera & Emmanuel Chartier-Kastler

  11. Royal Hallamshire Hospital, Sheffield, UK

    Sheilagh Reid

  12. Department of Urology, Hospital de São João, Porto, Portugal

    Francisco Cruz

Authors
  1. Evgeniy Kreydin
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  2. Blayne Welk
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  3. Doreen Chung
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  4. Quentin Clemens
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  5. Claire Yang
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  6. Teresa Danforth
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  7. Angelo Gousse
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  8. Stephanie Kielb
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  9. Stephen Kraus
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  10. Altaf Mangera
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  11. Sheilagh Reid
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  12. Nicole Szell
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  13. Francisco Cruz
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  14. Emmanuel Chartier-Kastler
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  15. David A. Ginsberg
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Contributions

EK, BW, DC, QC, CY, TD, AG, SK, SK, AM, SR, NS, FC, and EC-K: data analysis and manuscript writing. DG: project development, data collection, data analysis, and manuscript writing.

Corresponding author

Correspondence to David A. Ginsberg.

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The authors listed above do not report any conflicts of interest, individually, or as a group.

Human/animal research statement

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

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No informed consent was required, since no studies involving human subjects were undertaken.

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Kreydin, E., Welk, B., Chung, D. et al. Surveillance and management of urologic complications after spinal cord injury. World J Urol 36, 1545–1553 (2018). https://doi.org/10.1007/s00345-018-2345-0

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  • DOI: https://doi.org/10.1007/s00345-018-2345-0

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