Skip to main content
SpringerLink
Log in

Spinal Cord Injury

  • Reference work entry
  • First Online:
Handbook of Neurourology

  • 428 Accesses

Abstract

There are multiple causes of spinal cord injury, and most result in neurourological dysfunction. Bladder dysfunction is evident from the time of injury and requires prompt diagnosis and appropriate management to protect the upper urinary tract. Chronic neurogenic bladder function is variable depending on the level of spinal injury. Accurate and objective assessment involving videourodynamics can optimize appropriate multimodality treatment while minimizing the risk of complications. The management plan involves multidisciplinary care and aims to achieve low pressure storage, maintain continence, protect the upper tracts, and provide an acceptable quality of life through holistic care. Long-term surveillance is important to preserve these qualities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 999.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. J.F. Ditunno, W. Young, W.H. Donovan, G. Creasey, The international standards booklet for neurological and functional classification of spinal cord injury. Spinal Cord 32(2), 70–80 (1994)

    Article  Google Scholar 

  2. M.A. McColl, J. Walker, P. Stirling, R. Wilkins, P. Corey, Expectations of life and health among spinal cord injured adults. Spinal Cord 35, 818–828 (1997)

    Article  CAS  PubMed  Google Scholar 

  3. E. Garshick, A. Kelley, S.A. Cohen, A. Garrison, C.G. Tun, D. Gagnon, R. Brown, A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord 43(7), 408–416 (2005)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. A.B. Jackson, M. Dijkers, M.J. DeVivo, R.B. Poczatek, A demographic profile of new traumatic spinal cord injuries: Change and stability over 30 years. Arch. Phys. Med. Rehabil. 85(11), 1740–1748 (2004)

    Article  PubMed  Google Scholar 

  5. M.S. Alexander, F. Biering-Sorensen, D. Bodner, N.L. Brackett, D. Cardenas, S. Charlifue, G. Creasey, V. Dietz, J. Ditunno, W. Donovan, S.L. Elliott, International standards to document remaining autonomic function after spinal cord injury. Spinal Cord 47(1), 36–43 (2009)

    Article  CAS  PubMed  Google Scholar 

  6. J.F. Ditunno, J.W. Little, A. Tessler, A.S. Burns, Spinal shock revisited: A four-phase model. Spinal Cord 42(7), 383–395 (2004)

    Article  CAS  PubMed  Google Scholar 

  7. A.B. Rossier, B.A. Fam, M. Dibenedetto, et al., Urodynamics in spinal shock patients. J. Urol. 122, 783 (1979)

    Article  CAS  PubMed  Google Scholar 

  8. M. Bywater, J. Tornic, U. Mehnert, T.M. Kessler, Detrusor acontractility after acute spinal cord injury—Myth or reality? J. Urol. 199(6), 1565–1570 (2018)

    Article  PubMed  Google Scholar 

  9. K.D. Ethans, A.R. Casey, R.J. Bard, M.P. Namaka, Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA. Degenerat. Neurol. Neuromusc. Dis. 2014(4), 65–73 (2014)

    Google Scholar 

  10. J.P. Norris, D.R. Staskin, History, physical examination, and classification of neurogenic voiding dysfunction. Urol. Clin. N. Am. 23(3), 337–344 (1996)

    Article  CAS  Google Scholar 

  11. S. Moslavac, I. Dzidic, Z. Kejla, Neurogenic detrusor overactivity: Comparison between complete and incomplete spinal cord injury patients. Neurourol. Urodyn. 27(6), 504–506 (2008)

    Article  CAS  PubMed  Google Scholar 

  12. A. Curt, B. Nitsche, B. Rodic, B. Schurch, V. Dietz, Assessment of autonomic dysreflexia in patients with spinal cord injury. J. Neurol. Neurosurg. Psychiatry 62(5), 473–477 (1997)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. I. Itorai, R. Kim, M. Vulpe, H. Kasravi, W. Ho, Fatal cerebral hemorrhage due to autonomic dysreflexia in a tetraplegic patient: case report and review. Paraplegia 30, 355–360 (1992)

    Google Scholar 

  14. K.J. Weld, M.J. Graney, R.R. Dmochowski, Differences in bladder compliance with time and associations of bladder management with compliance in spinal cord injured patients. J. Urol. 163(4), 1228–1233 (2000)

    Article  CAS  PubMed  Google Scholar 

  15. Blok, B., Pannek, J., Castro-Diaz, D., del Popolo, G., Groen, J., Hamid, R., Karsenty, G., Kessler, T.M. EAU Guidelines on Neuro-Urology 2016. Available from http://uroweb.org/guideline/neuro-urology/

    Google Scholar 

  16. Consortium for spianl cord, Acute management of autonomic dysreflexia: adults with spinal cord injury presenting to health-care facilities. J. Spinal Cord Med. 20(3), 284–308 (1997)

    Article  Google Scholar 

  17. P. Costa, B. Perrouin-Verbe, A. Colvez, J. Didier, P. Marquis, A. Marrel, et al., Quality of life in spinal cord injury pateints with urinary difficulties. Development and validation of qualiveen. Eur. Urol. 39(1), 107–113 (2001)

    Article  CAS  PubMed  Google Scholar 

  18. NICE Urinary incontinence in neurological disease: assessment and management. Clinical guideline [CG148]. Available from https://www.nice.org.uk/guidance/CG148/chapter/1-Guidance#monitoring-and-surveillance-protocols. Accessed 9/3/17

  19. R. Lawrenson, J.J. Wyndalaele, I. Vlachonikolis, C. Farmer, S. Glickman, Renal failure in patients with neurogenic lower urinary tract dysfunction. Neuroepidemiology 20(2), 38–43 (2001)

    Article  Google Scholar 

  20. K.J. Weld, R.R. Dmochowski, Effect of bladder management on urological complications in spinal cord injured patients. J. Urol. 163(3), 768–772 (2000)

    Article  CAS  PubMed  Google Scholar 

  21. J. Pannek, Transitional cell carcinoma in patients with spinal cord injury: A high risk malignancy? Urology 59(2), 240–244 (2002)

    Article  PubMed  Google Scholar 

  22. J.M. Kaufman, B. Fam, S.C. Jacobs, F. Gabilondo, S. Yalla, J.P. Kane, et al., Bladder cancer and squamous metaplasia in spinal cord injury patients. J. Urol. 118(6), 967–971 (1977)

    Article  CAS  PubMed  Google Scholar 

  23. Spinal Cord Medicine Consortium, Clinical practice guidelines: Neurogenic bowel management in adults with spinal cord injury. J. Spinal Cord Med. 21(3), 248–293 (1998)

    Article  Google Scholar 

  24. P. Christensen, G. Bazzocchi, M. Coggrave, R. Abel, C. Hultling, K. Krogh, S. Media, S. Laurberg, A randomized, controlled trial of Transanal irrigation versus conservative bowel management in spinal cord–injured patients. Gastroenterology 131(3), 738–747 (2006)

    Article  PubMed  Google Scholar 

  25. R. Levi, C. Hultling, M.S. Nash, A. Seiger, The Stockholm spinal cord injury study: 1. Medical problems in a regional SCI population. Paraplegia 33(6), 308–315 (1995)

    CAS  PubMed  Google Scholar 

  26. F. Giuliano, C. Hultling, W.S. El Masry, M.D. Smith, I.H. Osterloh, M. Orr, M. Maytom, Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Ann. Neurol. 46(1), 15–21 (1999)

    Article  CAS  PubMed  Google Scholar 

  27. D. Deforge, J. Blackmer, C. Garritty, F. Yazdi, V. Cronin, N. Barrowman, M. Fang, V. Mamaladze, L. Zhang, M. Sampson, D. Moher, Male erectile dysfunction following spinal cord injury: A systematic review. Spinal Cord 44(8), 465–473 (2006)

    Article  CAS  PubMed  Google Scholar 

  28. D. DeForge, J. Blackmer, C. Garritty, F. Yazdi, V. Cronin, N. Barrowman, M. Fang, V. Mamaladze, L. Zhang, M. Sampson, D. Moher, Fertility following spinal cord injury: A systematic review. Spinal Cord 43(12), 693–703 (2005)

    Article  CAS  PubMed  Google Scholar 

  29. M.L. Sipski, C.J. Alexander, R. Rosen, Sexual arousal and orgasm in women: Effects of spinal cord injury. Ann. Neurol. 49(1), 35–44 (2001)

    Article  CAS  PubMed  Google Scholar 

  30. M. Stöhrer, G. Kramer, D. Löchner-Ernst, M. Goepel, F. Noll, H. Rübben, Diagnosis and treatment of bladder dysfunction in spinal cord injury patients. Eur. Urol. Update Ser. 3, 170–175 (1994)

    Google Scholar 

  31. M.B. Chancellor, R.U. Anderson, T.B. Boone, Pharmacotherapy for neurogenic detrusor overactivity. Am. J. Phys. Med. Rehabil. 85, 536–545 (2006)

    Article  PubMed  Google Scholar 

  32. G. Buyse, K. Waldeck, C. Verpoorten, H. Bjrpo, P. Casaer, K.E. Andersson, Intravesical oxybutynin for neurogenic bladder dysfunction: less systemic side effects due to reduced first pass metabolism. J. Urol. 160(3 Pt 1), 892–896 (1998)

    CAS  PubMed  Google Scholar 

  33. M. Shohrer, J. Pannek, Surgery to improve reservoir function, in Textbook of the neuropathic bladder, ed. by J. Corcos, E. Schick, 2nd edn., (Informa Healthcare, London, 2008), pp. 634–641

    Google Scholar 

  34. B. Perrouin-Verbe, J.J. Labat, I. Richard, I. Mauduyt de la Greve, J.M. Buzelin, J.F. Mathe, Clean intermittent catheterisation from the acute period in spinal cord injury patients. Long term evaluation of urethral and genital tolerance. Paraplegia 33(11), 619–624 (1995)

    CAS  PubMed  Google Scholar 

  35. L.W. Chan, T.L. Griebling, E.P. Arnold, P.S. Chu, P.W. New, A. Wagg, Special considerations in the urological management of the older spinal cord injury patient. World J. Urol. 36(10), 1603–1611 (2018)

    Article  PubMed  Google Scholar 

  36. H.S. Talbot, E.M. Mahony, S.R. Jaffee, The effect of prolonged urethral catheterization: I. persistence of normal renal structure and function. J. Urol. 81, 138–143 (1959)

    Article  CAS  PubMed  Google Scholar 

  37. R. Böthig, S. Hirschfeld, R. Thietje, Quality of life and urological morbidity in tetraplegics with artificial ventilation managed with suprapubic or intermittent catheterisation. Spinal Cord 50(3), 247–251 (2012)

    Article  PubMed  Google Scholar 

  38. T. Sugimura, E. Arnold, S. English, J. Moore, Chronic suprapubic catheterization in the management of patients with spinal cord injuries: Analysis of upper and lower urinary tract complications. BJU Int. 101(11), 1396–1400 (2008)

    Article  PubMed  Google Scholar 

  39. J.F. Kalisvaart, H.K. Katsumi, L.D. Ronningen, R.M. Hovey, Bladder cancer in spinal cord injury patients. Spinal Cord 48, 257–261 (2010)

    Article  CAS  PubMed  Google Scholar 

  40. R. Hamid, J. Bycroft, M. Arya, P.J. Shah, Screening cystoscopy and biopsy in patients with neuropathic bladder and chronic suprapubic indwelling catheters: Is it valid? J. Urol. 170, 425–427 (2003)

    Article  CAS  PubMed  Google Scholar 

  41. D. McClurg, R.G. Ashe, K. Marshall, A.S. Lowe-Strong, Comparison of pelvic floor muscle training, electromyography, biofeedback and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: A randomised pilot study. Neurourol. Urodyn. 25, 337–348 (2006)

    Article  CAS  PubMed  Google Scholar 

  42. B. Schurch, D.M. Schmid, M. Sthmidh, Treatment of neurogenic incontinence with botulinum toxin A. N. Engl. J. Med. 342(9), 665 (2000)

    Article  CAS  PubMed  Google Scholar 

  43. A. Haferkamp, B. Schurch, A. Reitz, U. Krengel, J. Grosse, G. Kramer, et al., Lack of ultrastructural detrusor changes following endoscopic injection of botulinum toxin type A in overactive neurogenic bladder. Eur. Urol. 46, 784–791 (2004)

    Article  CAS  PubMed  Google Scholar 

  44. G. Del Popolo, M.T. Filocamo, V. Li Marzi, A. Macchiarella, F. Cecconi, G. Lombardi, G. Nicita, Neurogenic detrusor overactivity treated with english botulinum toxin a: 8-year experience of one single centre. Eur. Urol. 53, 1013–1019 (2008)

    Article  PubMed  Google Scholar 

  45. F. Cruz, S. Herschorn, P. Aliotta, et al., Efficacy and safety of OnabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: A randomised, double-blind, placebo-controlled trial. Eur. Urol. 60, 742–750 (2011)

    Article  CAS  PubMed  Google Scholar 

  46. J. Khastgir, R. Hamid, M. Arya, N. Shah, P.J. Shah, Surgical and patient reported outcomes of ‘clam’ augmentation ileocystoplasty in spinal cord injured patients. Eur. Urol. 43, 263–269 (2003)

    Article  CAS  PubMed  Google Scholar 

  47. T.J. Greenwell, S.N. Venn, A.R. Mundy, Augmentation cystoplasty. BJU Int. 88, 511–525 (2001)

    Article  CAS  PubMed  Google Scholar 

  48. W.W. Leng, H.J. Blalock, W.H. Fredriksson, S.F. English, E.J. McGuire, Enterocystoplasty or detrusor myomectomy? Comparison of indications and outcomes for bladder augmentation. J. Urol. 161, 758–763 (1999)

    Article  CAS  PubMed  Google Scholar 

  49. J.K. Bennett, B.G. Green, J.E. Foote, M. Gray, Collagen injections for intrinsic sphincter deficiency in the neuropathic urethra. Paraplegia 33, 697–700 (1995)

    CAS  PubMed  Google Scholar 

  50. R. Hamid, M. Arya, J. Khastgir, H.R. Patel, P.J. Shah, The treatment of male stress urinary incontinence with polydimethylsiloxane in compliant bladders following spinal cord injury. Spinal Cord 41, 286–289 (2003)

    Article  CAS  PubMed  Google Scholar 

  51. R.M. Decter, Use of the fascial sling for neurogenic incontinence: lessons learned. J. Urol. 150, 683–686 (1993)

    Article  CAS  PubMed  Google Scholar 

  52. A. Abdul-Rahman, K.H. Attar, R. Hamid, P.J. Shah, Long-term outcome of tension-free vaginal tape for treating stress incontinence in women with neuropathic bladders. BJU Int. 106, 827–830 (2010)

    Article  PubMed  Google Scholar 

  53. E.C. Kastler, S. Genevois, X. Gamé, P. Denys, F. Richard, A. Leriche, J.P. Saramon, A. Ruffion, Treatment of neurogenic male urinary incontinence related to intrinsic sphincter insufficiency with an artificial urinary sphincter: a French retrospective multicentre study. BJU Int. 107(3), 426–432 (2011)

    Article  Google Scholar 

  54. P. Patki, R. Hamid, P.J. Shah, M. Craggs, Long-term efficacy of AMS 800 artificial urinary sphincter in male patients with urodynamic stress incontinence due to spinal cord lesion. Spinal Cord 44, 297–300 (2006)

    Article  CAS  PubMed  Google Scholar 

  55. M.B. Chancellor, M.J. Erhard, P.J. Kiilholma, S. Karasick, D.A. Rivas, Functional urethral closure with pubovaginal sling for destroyed female urethra after long-term urethral catheterization. Urology 43, 499–505 (1994)

    Article  CAS  PubMed  Google Scholar 

  56. P.E. Zimmern, H.R. Hadley, G.E. Leach, S. Raz, Transvaginal closure of the bladder neck and placement of a suprapubic catheter for destroyed urethra after long-term indwelling catheterization. J. Urol. 134, 554–557 (1985)

    Article  CAS  PubMed  Google Scholar 

  57. G.S. Brindley, An implant to empty the bladder or close the urethra. J. Neurol. Neurosurg. Psychiatry 40, 358–369 (1977)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. B. Schurch, B. Rodic, D. Jeanmonod, Posterior sacral rhizotomy and intradural anterior sacral root stimulation for treatment of the spastic bladder in spinal cord injured patients. J. Urol. 157, 610–614 (1997)

    Article  CAS  PubMed  Google Scholar 

  59. R.A. Schmidt, E.A. Tanagho, Feasibility of controlled micturition through electric stimulation. Urol. Int. 34, 199–230 (1979)

    Article  CAS  PubMed  Google Scholar 

  60. P.M. Braun, H. Baezner, C. Seif, G. Boehler, S. Bross, C.C. Eschenfelder, P. Alken, M. Hennerici, P. Juenemann, Alterations of cortical electrical activity in patients with sacral neuromodulator. Eur. Urol. 41, 562–566 (2002)

    Article  CAS  PubMed  Google Scholar 

  61. T.M. Kessler, D. La Framboise, S. Trelle, C.J. Fowler, G. Kiss, J. Pannek, B. Schurch, K.D. Sievert, D.S. Engeler, Sacral neuromodulation for neurogenic lower urinary tract dysfunction: Systematic review and meta-analysis. Eur. Urol. 58(6), 865–874 (2010)

    Article  PubMed  Google Scholar 

  62. S.A. Kaplan, M.B. Chancellor, J.G. Blaivas, Bladder and sphincter behaviour in patients with spinal cord injury. J. Urol. 146, 113 (1991)

    Article  CAS  PubMed  Google Scholar 

  63. S. Seoane-Rodríguez, J. Sánchez R-Losada, A. Montoto-Marqués, S. Salvador-de la Barrera, M.E. Ferreiro-Velasco, L. Alvarez-Castelo, B. Balsa-Mosquera, A. Rodríguez-Sotillo, Long-term follow-up study of intraurethral stents in spinal cord injured patients with detrusor-sphincter dyssynergia. Spinal Cord 45, 621–626 (2007)

    Article  PubMed  Google Scholar 

  64. R. Hamid, M. Arya, H.R. Patel, P.J. Shah, The mesh wallstent in the treatment of detrusor external sphincter dyssynergia in men with spinal cord injury: a 12-year follow-up. BJU Int. 91, 51–53 (2003)

    Article  CAS  PubMed  Google Scholar 

  65. M.W. Phelan, M. Franks, G.T. Somogyi, T. Yokoyama, M.O. Fraser, J.P. Lavelle, N. Yoshimura, M.B. Chancellor, Botulinum toxin urethral sphincter injection to restore bladder emptying in men and women with voiding dysfunction. J. Urol. 165, 1107–1110 (2001)

    Article  CAS  PubMed  Google Scholar 

  66. A. Liard, E. Séquier-Lipszyc, A. Mathiot, P. Mitrofanoff, The Mitrofanoff procedure: 20 years later. J. Urol. 165, 2394–2398 (2001)

    Article  CAS  PubMed  Google Scholar 

  67. J.A. Sylora, R. Gonzalez, M. Vaughn, Y. Reinberg, Intermittent self-catheterization by quadriplegic patients via a catheterizable Mitrofanoff channel. J. Urol. 157, 48–50 (1997)

    Article  CAS  PubMed  Google Scholar 

  68. D. Castro-Diaz, D. Barrett, P. Grise, I. Perkash, M. Stohrer, A. Stone, P. Vale, Surgery for the neuropathic patient, in Incontinence, ed. by P. Abrams, S. Khoury, A. Wein, 2nd edn., (Health Publication, Plymouth, 2002), pp. 865–891

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Taranaki Base Hospital, Plymouth, New Zealand

    Christian Robinson & Hazel Ecclestone

  2. University College London Hospitals & London Spinal Injuries Unit, Stanmore, UK

    Rizwan Hamid

Authors
  1. Christian Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hazel Ecclestone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rizwan Hamid
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology Department of Neurourology, China Rehabiliation Research Center China Rehabilitation Science InstituteCapital Medical University, Beijing, China

    Limin Liao

  2. Department of Urology, Medical University Innsbruck, University Hospital, Innsbruck, Austria

    Helmut Madersbacher

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Robinson, C., Ecclestone, H., Hamid, R. (2023). Spinal Cord Injury. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_63

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-1659-7_63

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-1658-0

  • Online ISBN: 978-981-99-1659-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation