Research on complications and bladder management of the chronic phase spinal cord injury in China

This study aimed to investigate common complications during the chronic phase of spinal cord injury (SCI) and to assess bladder management methods and their associated complications in patients with neurogenic lower urinary tract dysfunction (NLUTD). A retrospective analysis was performed using clinical data from chronic-phase SCI patients across multiple centers in China. The study population included individuals diagnosed with SCI and admitted between January 1, 2017, and December 31, 2022. Chi-square tests were used to evaluate differences in the distribution of complications, disease duration, bladder management methods, and urinary complications. Univariate and multivariate analyses were conducted to identify risk factors for urinary complications. A total of 849 SCI patients from 28 provinces in China were included, showing significant demographic and clinical differences between traumatic SCI (TSCI) and non-traumatic SCI (NTSCI). Urinary tract infection (59.95%) and bowel-related complications, such as constipation (62.17%), were the most frequently reported complications. Additionally, the incidences of osteoporosis (38.50%), neuropathic pain (29.99%), bowel incontinence (12.06%), and hydronephrosis (11.91%) were also high. NLUTD was present in 90.58% of SCI patients. Among these, intermittent catheterization was associated with significantly lower rates of urological complications compared to indwelling catheterization (p = 0.025). Multivariate analysis identified bladder management method as a significant risk factor for urinary complications, with indwelling catheterization associated with a higher risk of urinary stones (p < 0.001) compared to intermittent catheterization. The high prevalence of bowel- and urological-related complications among Chinese SCI patients highlights the need for increased societal attention. In terms of bladder management, intermittent catheterization may provide greater benefits compared to indwelling catheterization. Further research and education are necessary to promote intermittent catheterization as a standardized bladder management approach for SCI patients.