A survey of clinical practice concerning long-term follow-up of neurogenic lower urinary tract dysfunction due to spinal cord injury in Italy

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1863899 · Published: January 1, 2022

Simple Explanation

This study assesses how Italian medical centers monitor and treat urinary problems in patients with spinal cord injuries (SCI) over the long term. The researchers compared the practices in Italy with guidelines from other countries to see if they are following international standards. The study found that while most Italian centers generally follow international guidelines, there is some variation in how often they conduct follow-up examinations.

Study Duration

Not specified

Participants

One physician at each of 21 Italian centers following SCI patients

Evidence Level

Survey

Key Findings

1
Most Italian centers recommend yearly follow-up visits and ultrasound examinations for SCI patients with neurogenic lower urinary tract dysfunction (NLUTD).
2
There is a significantly higher frequency of follow-up for suprasacral SCI compared to sacral SCI, indicating a stricter monitoring approach for more severe cases.
3
A significant proportion of Italian centers do not have standard protocols for antibiotic prophylaxis of urinary tract infections (UTIs).

Research Summary

The study aimed to evaluate the current clinical practice in Italy for the long-term follow-up of neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI). The survey revealed that while most Italian centers adhere to international guidelines regarding yearly visits and urinary tract examinations, heterogeneity exists in the frequency of follow-up examinations. The authors suggest a tailored approach to SCI patient care, minimizing unnecessary examinations and grouping tests to improve patient compliance and reduce healthcare costs.

Practical Implications

Harmonization of Practices

Italian centers should aim to standardize their urological follow-up protocols for SCI patients to ensure consistent and optimal care.

Tailored Approach

Individualized follow-up plans that consider the specific clinical conditions of patients can improve compliance and reduce unnecessary healthcare costs.

Enhanced Neuro-Urologist Involvement

Promoting the consistent presence of neuro-urologists in the follow-up care can improve the management of urological complications, especially recurrent UTIs.

Study Limitations

1
Data may have been influenced by self-report bias inherent in survey-based studies.
2
The questionnaire was not pretested, posing a risk of misinterpretation by the surveyed centers.
3
The presence of different clinical settings in the sample may have introduced sources of variability.

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