Urological Management and Complications in Spinal Cord Injury Patients: a 40- to 50-Year Follow-Up Study

To assess the management and types of urological complications in spinal cord injury (SCI) patients and to explore the risk factors for these complications.

43 SCI patients with a median follow-up of 45 (range 40 to 50) years were included in this retrospective study. All medical charts were reviewed for demographics, urological complications and bladder management.

Recurrent urinary tract infection (UTI) was noted in all patients, with an average incidence of 6.1 cases/5-year per person. UTI incidence peaked in the 1st and the 10th 5-year intervals. Beside UTI the most common complications were: bladder stone (49%), hydronephrosis (47%), vesicoureteral reflux (33%). Most complications initially occurred during the first 25 years post injury. Male gender, cervical injury and condom catheter use were closely related to complications, particularly UTI and renal insufficiency. The bladder managements used for the longest period were condom catheter in males (79%) and clean intermittent catheterization in females (33%), with an average maintenance of 23.6 and 38 years, respectively.

With long follow-up, a wide and complex range of urologic complications occurred in SCI patients and continue to do so throughout the period of follow-up. A greater risk for urologic complications may be seen with certain factors (male gender, cervical SCI, condom catheter use); however, all patients with SCI are at risk for urinary complications over time. Thus, even long-term patients that are thought to be "stable" require regular follow-up and surveillance.

Urology. 2017 Mar 16 [Epub ahead of print]

Yunliang Gao, Teresa Danforth, David Ginsberg

Department of Urology, The Second Xiangya Hospital, Central South University, Changsha 410011, China; Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA., Department of Urology, SUNY Buffalo School of Medicine and Biomedical Sciences, Buffalo General Hospital, Buffalo, NY 14203, USA., Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA; Department of Urology, Rancho Los Amigos National Rehabilitation Center, Downey, CA 90242, USA. Electronic address: .