Urological Management at Discharge from Acute Spinal Cord Injury Rehabilitation: A Descriptive Analysis from a Population-based Prospective Cohort

European Urology Open Science, 2022 · DOI: https://doi.org/10.1016/j.euros.2022.01.005 · Published: January 16, 2022

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

This study describes how people with spinal cord injuries (SCI) manage their bladder issues when they leave rehabilitation. It looks at different methods like using catheters or medications. The study found that most people leaving rehab still have urinary problems, especially those with complete SCIs. Women are more likely to have urinary incontinence. The information from this study can help improve guidelines for managing bladder problems in people with SCI.

Study Duration

2013 to 2020

Participants

602 adults undergoing specialized postacute SCI rehabilitation

Evidence Level

Not specified

Key Findings

1
At discharge, 82% of patients had lower urinary tract symptoms (LUTS) or managed neurogenic lower urinary tract dysfunction (NLUTD).
2
The risk of urinary incontinence was elevated in females and with complete lesions.
3
Voiding dysfunction was most commonly managed with intermittent catheterization (39%), followed by indwelling catheterization (22%).

Research Summary

This population-based study describes NLUTD management at discharge from SCI rehabilitation, finding LUTS or managed NLUTD predominantly determined by AIS grade. Female sex and lesion completeness predicted incontinence. Intermittent catheterization, followed by indwelling, was the most common management approach for voiding dysfunction. The study suggests a need for further research to identify the source of potential sex differences in incontinence and etiological differences in medication use.

Practical Implications

Reference for evaluation

The description of neuro-urological management can serve as a reference for evaluating and improving guidelines for clinical management of NLUTD in SCI.

Sex-specific management

The data indicate a need for sex-specific neuro-urological management research to address the higher risk of urinary incontinence in females.

Individualized clinical management

The findings support the development of individualized clinical management strategies for NLUTD in SCI, taking into account patient characteristics.

Study Limitations

1
Urodynamic and renal function data were not collected.
2
Indications for treatment or management were not recorded.
3
The study was not powered to conclusively evaluate differences in management related to specific NTSCI etiologies.

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