The use of urologic investigations among patients with traumatic spinal cord injuries

Research and Reports in Urology, 2016 · DOI: 10.2147/RRU.S99840 · Published: February 22, 2016

Simple Explanation

This study examines how often patients with traumatic spinal cord injuries (TSCI) receive urologic tests like urodynamics, renal imaging, and cystoscopy. The study found that while most patients receive renal imaging at least once, fewer undergo urodynamics or cystoscopy regularly. The use of these tests doesn't always match what urologists recommend, suggesting a gap between ideal practices and what happens in the real world.

Study Duration

10 years (2002-2012)

Participants

1,551 adult TSCI patients

Evidence Level

Retrospective cohort study

Key Findings

1
Only half of TSCI patients undergo urodynamics or cystoscopy at least once during follow-up, while the majority receive renal imaging.
2
Few patients receive regular, yearly urologic testing despite guideline recommendations.
3
Urodynamics are less likely in older patients and those with higher comorbidity.

Research Summary

This retrospective cohort study assessed the utilization of urologic investigations (urodynamics, renal imaging, cystoscopy) among traumatic spinal cord injury (TSCI) patients in Ontario, Canada, between 2002 and 2012. The study found that while renal imaging was commonly performed, urodynamics and cystoscopy were less frequent, and regular yearly testing was rare. Patient characteristics such as age, comorbidity, and lesion level influenced the likelihood of receiving urologic investigations.

Practical Implications

Guideline Adherence

Highlights the need to address the gap between guideline recommendations and real-world practice in urologic management of TSCI patients.

Targeted Interventions

Suggests focusing on older patients, those with comorbidities, and individuals with quadriplegia to improve urodynamic testing rates.

Future Research

Calls for prospective studies to evaluate the impact of different follow-up regimens on patient outcomes and to establish quality-of-care indicators.

Study Limitations

1
Use of administrative data with limited clinical details.
2
Inability to determine the reason for urologic investigations (screening vs. symptoms).
3
Lack of data on whether urologic investigations improve patient outcomes.

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