Complications of different methods of urological management in people with neurogenic bladder secondary to spinal cord injury

The Journal of Spinal Cord Medicine, 2024 · DOI: 10.1080/10790268.2023.2188393 · Published: March 1, 2024

Simple Explanation

This study investigates the relationship between different methods of managing neurogenic bladder in people with spinal cord injury (SCI) and the occurrence of urological complications. The study found that long-term use of indwelling urethral catheters (IUC) was associated with a higher risk of urinary tract infections (UTI) compared to other methods like suprapubic catheters (SPC) or self-voiding. The findings suggest that choosing a bladder management method other than IUC, such as SPC, may reduce the risk of UTIs in people with SCI.

Study Duration

24–300 months

Participants

207 individuals with SCI

Evidence Level

Retrospective cohort study

Key Findings

1
Long-term IUC use was associated with a higher incidence of UTI in people with SCI.
2
Compared with the IUC group, the SPC and self-voiding groups had significantly lower risks of developing UTI.
3
The SPC group tended to have a lower risk of epididymitis than the IUC group.

Research Summary

This retrospective cohort study investigated the association between different urological management methods and urological complications in patients with spinal cord injury (SCI). The study found that long-term indwelling urethral catheter (IUC) use was associated with a higher risk of urinary tract infection (UTI) compared to other methods such as suprapubic catheter (SPC) and self-voiding. The findings suggest that SPC may be a preferable alternative to IUC for managing neurogenic bladder in SCI patients to minimize the risk of UTI.

Practical Implications

Clinical Decision-Making

These findings can inform shared clinical decision-making regarding bladder management methods for individuals with SCI.

Infection Prevention

The study highlights the importance of considering alternatives to IUC to reduce the risk of UTI in SCI patients.

Alternative Management

SPC may be a more appropriate choice than IUC for individuals with SCI who are unable to perform self-catheterization.

Study Limitations

1
The timing of and reasons for switching urological-management approaches during follow-up were not accounted for.
2
Retrospective design may have introduced a misclassification bias and reviewer bias.
3
Detailed information about other factors (e.g. menopause, sexual activity, pregnancy, concomitant medications, pelvic prolapse, prior history of UTI, and urodynamic study data) is not readily available.

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