Surveillance and management of urologic complications after spinal cord injury

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.

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).

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.

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.

World journal of urology. 2018 May 29 [Epub]

Evgeniy Kreydin, Blayne Welk, Doreen Chung, Quentin Clemens, Claire Yang, Teresa Danforth, Angelo Gousse, Stephanie Kielb, Stephen Kraus, Altaf Mangera, Sheilagh Reid, Nicole Szell, Francisco Cruz, Emmanuel Chartier-Kastler, David A Ginsberg

USC Institute of Urology, 1441 Eastlake Avenue, suite 7414, Los Angeles, CA, 90033, USA., Division of Urology, The University of Western Ontario, London, ON, Canada., Columbia University College of Physicians and Surgeons, New York, NY, USA., University of Michigan, Ann Arbor, MI, USA., University of Washington, Seattle, WA, USA., Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA., Bladder Health and Reconstructive Urology Institute, Miami, FL, USA., Northwestern Fienberg School of Medicine, Chicago, IL, USA., University of Texas, San Antonio, San Antonio, TX, USA., Department of Urology, Pitié-Salpêtrière, Paris, France., Royal Hallamshire Hospital, Sheffield, UK., Department of Urology, Hospital de São João, Porto, Portugal., USC Institute of Urology, 1441 Eastlake Avenue, suite 7414, Los Angeles, CA, 90033, USA. .

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