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International Urology and Nephrology

, Volume 50, Issue 6, pp 1005–1016 | Cite as

Recommendations for urological follow-up of patients with neurogenic bladder secondary to spinal cord injury

  • Mikolaj Przydacz
  • Piotr Chlosta
  • Jacques Corcos
Urology - Review

Abstract

Purpose

To review currently available guidelines and recommendations regarding urological follow-up of patients after spinal cord injury (SCI) and present an evidence-based summary to support clinicians in their clinical practice.

Methods

Maximum data were collected according to different methods, including searches with multiple and specific keywords, reference checks, gray literature searches (congress reports, working papers, statement documents), and browsing-related Web site access. Obtained data were analyzed with the modified version of the Oxford grading system for recommendations using levels of evidence (LE) and grades of recommendation (GR).

Results

Different surveillance strategies exist, but there is no consensus among authors and organizations. As a result, practice patterns vary around the world. The present review indicates that proper urological follow-up of SCI patients should consist of medical history (LE 1-4, GR B-C), clinical examination (LE 4, GR C), renal laboratory tests (LE 1-3, GR B), imaging surveillance of the upper urinary tract (LE 1-3, GR A-B), urodynamic study (LE 2-4, GR B-C), and cystoscopy/cytology (LE 1-4, GR D). Clinicians agree that SCI patients should be followed up regularly with an individually tailored approach. A 1-year follow-up schedule seems reasonable in SCI patients without additional risk factors of renal deterioration (LE 3-4, GR C). In those who manifest risk factors, report changes in bladder behavior, or present with already developed complications of neurogenic bladder dysfunction, follow-up plans should be modified with more frequent checkups (LE 4, GR C). Urodynamic study should be repeated and considered as a routine monitoring strategy.

Conclusion

Individuals with neurogenic lower urinary tract dysfunction are at increased risk of multiple complications. Nevertheless, proper follow-up after SCI improves the prognosis for these patients and their quality of life.

Keywords

Spinal cord injury Neurogenic bladder Neurogenic lower urinary tract dysfunction Follow-up Monitoring 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

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

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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Mikolaj Przydacz
    • 1
    • 2
  • Piotr Chlosta
    • 2
  • Jacques Corcos
    • 1
  1. 1.Department of Urology, Jewish General HospitalMcGill UniversityMontrealCanada
  2. 2.Department of UrologyJagiellonian University, Medical CollegeKrakówPoland

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