Association of bladder trabeculation and neurogenic bladder with spinal cord injury

Journal of International Medical Research, 2022 · DOI: 10.1177/03000605221104768 · Published: June 1, 2022

Simple Explanation

This study investigates the relationship between bladder trabeculation (irregular bladder contours) and neurogenic bladder in patients with spinal cord injuries (SCI). It looks at how clinical symptoms and urodynamic parameters (bladder function measurements) relate to the severity of trabeculation. The researchers compared different grades of bladder trabeculation with SCI-related clinical factors and bladder-related urodynamic measures to see which factors were most strongly associated with trabeculation. The study found that longer disease duration, smaller bladder volume, involuntary bladder contractions, and vesicoureteral reflux (VUR) were moderately correlated with the severity of bladder trabeculation in patients with suprasacral SCI.

Study Duration

Not specified

Participants

337 SCI patients with neurogenic bladder

Evidence Level

Level 3, Retrospective Chart Review

Key Findings

1
Disease duration, bladder capacity, detrusor pressure, peak detrusor pressure, and compliance were significantly different between different grades of bladder trabeculation.
2
Vesicoureteral reflux (VUR) showed the strongest positive correlation with trabeculation grade (correlation coefficient 0.433).
3
Neurological level of injury (NLI), American Spinal Injury Association Impairment Scale (AIS) score, and detrusor sphincter dyssynergia (DSD) did not have a clear relationship with bladder trabeculation grade.

Research Summary

The study aimed to compare bladder-related clinical symptoms and urodynamic parameters according to trabeculation grade and identify factors with the highest correlations with trabeculation in neurogenic bladder caused by SCI. The results indicated that disease duration, bladder capacity, detrusor pressure, peak detrusor pressure values, and compliance were significantly different between different grades of bladder trabeculation. Vesicoureteral reflux was moderately correlated with trabeculation grade, while disease duration, involuntary detrusor contraction, and bladder filling volume showed weaker correlations.

Practical Implications

Clinical Monitoring

Regular monitoring of bladder function in SCI patients is crucial, especially focusing on disease duration, bladder capacity, and the presence of VUR.

Personalized Treatment

Treatment strategies should be tailored to address factors contributing to trabeculation, such as managing detrusor overactivity and preventing VUR.

Further Research

Future studies should investigate the long-term effects of different voiding methods (CIC vs. indwelling catheterization) on bladder trabeculation in SCI patients.

Study Limitations

1
The study is retrospective, which may introduce bias and limit causal inferences.
2
The accuracy of bladder trabeculation diagnoses was based on fluoroscopic images, which are less accurate than cystoscopy.
3
The study included repeated measurements of data, mixing initial and follow-up data, making it difficult to analyze the effects of medication on trabeculation.

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