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Bladder hypocompliance in the spinal cord injury population
R H Hackler1, M K Hall, T A Zampieri
1Division of Urology, McGuire Veterans Administration Medical Center, Richmond, Virginia.
The Journal of Urology
|June 1, 1989
Summary
Low bladder compliance is common in spinal cord injury (SCI) patients, significantly increasing the risk of upper urinary tract damage like hydronephrosis and reflux. Regular monitoring and management are crucial for SCI patients with low compliant bladders.
Area of Science:
- Urology
- Nephrology
- Neurology
Background:
- Spinal cord injury (SCI) can lead to bladder dysfunction.
- Low bladder compliance is a significant concern in SCI patients.
- The impact of low bladder compliance on upper urinary tracts requires further investigation.
Purpose of the Study:
- To determine the incidence of low bladder compliance in SCI patients.
- To evaluate the effects of low bladder compliance on upper urinary tract conditions such as hydronephrosis and reflux.
- To identify risk factors associated with low bladder compliance in SCI.
Main Methods:
- Retrospective evaluation of 254 SCI patients over 3 years.
- Urodynamic studies were performed to assess bladder compliance.
- Excretory urograms and/or renal ultrasounds were used to evaluate upper urinary tracts.
- Bladder compliance was defined as low if ≤20 cc at 100 cc volume.
Main Results:
- 17% of SCI patients (43/254) exhibited low bladder compliance.
- In patients with low bladder compliance, 64% had hydronephrosis and 46% had reflux.
- Patients with lower motor neuron lesions had a higher incidence (50%) of low bladder compliance compared to those with suprasacral lesions (10%).
Conclusions:
- Low bladder compliance is a frequent complication in SCI patients.
- Low bladder compliance poses a substantial risk to upper urinary tract health.
- Maintaining low detrusor pressures and ensuring frequent follow-up are essential for managing SCI patients with low compliant bladders.