Department Neuro-Urology, BG Trauma Hospital Hamburg, Hamburg, Germany.
Study Design: Mono-centric, retrospective study.
Analysis of correlation between bladder management and age in respirator-dependant high-tetraplegic patients. Additionally suprapubic catheter (SPC) and intermittent catheterisation (IC) were reviewed concerning urological complications and quality of life (QoL).
Setting: Level 1 trauma centre.
A QoL questionnaire 'International Consultation on Incontinence' (ICIQ-SF) was sent to 56 tetraplegic respirator device-dependant (RDD)-spinal cord injury (SCI) patients. Their scores concerning urological morbidity were reviewed. For analysis reasons they were divided in three groups: SPC, IC and others.
SPC 38, IC 12 and others 6 patients. Significant difference in age (SPC vs IC=49.9 vs 31.8 years) was observed but no disparity in gender. Within a follow-up period 2-26 years (median 8 years) significant urological complications in patients with IC (P< 0.05) were ascertained. These were in general minor complications. Especially renal deterioration or bladder cancer was not diagnosed in any of the group. The questionnaire return rate was high (83.9%) with complete answers (SPC=32, IC=11). Self assessment of QoL with ICIQ-SF revealed no significant difference for both groups on low level, but SPC patients tend to score better.
In our study, tetraplegic RDD-SCI patients with SPC suffered less urological complications and tend to score a better QoL. Therefore we recommend SPC as a serious alternative for these selected patients and concurrently underline the necessity of close urological surveillance at least annually.
Written by:
Böthig R, Hirschfeld S, Thietje R. Are you the author?
Reference: Spinal Cord. 2011 Aug 30. Epub ahead of print.
doi: 10.1038/sc.2011.94
PubMed Abstract
PMID: 21876550
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