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Cystometry Is Associated With Reduced Overall Mortality in Veterans With Suprasacral Spinal Cord Injury or Disease
John Hornberger1,2, John Lavelle1,2
1Department of Veterans Affairs Palo Alto Health Care System, Urology Section, Palo Alto, California, USA.
Neurourology and Urodynamics
|March 24, 2026
Summary
Cystometrogram use in veterans with spinal cord injuries was low, but it significantly reduced mortality risk over 20 years. This highlights the importance of adhering to neurogenic bladder surveillance protocols for improved survival outcomes.
Area of Science:
- Urology
- Neurosurgery
- Public Health
Background:
- Guidelines recommend cystometrogram for suprasacral spinal cord injury patients.
- Adherence to neurogenic bladder surveillance via urodynamics and its survival impact are understudied.
Purpose of the Study:
- Assess cystometrogram utilization in spinal cord injury patients.
- Determine the association between cystometrograms and survival rates.
Main Methods:
- Emulated a target trial for veterans with spinal cord injuries and no prior urological issues.
- Analyzed cystometrogram use and its association with mortality risk, controlling for confounders.
Main Results:
- 31% of 43,326 veterans underwent cystometrogram with a mean follow-up of 122 months.
- Cystometrogram was linked to a significant reduction in mortality risk (OR 0.74; P < 0.001).
- This survival benefit persisted over 20 years and was seen even with other preventative measures.
Conclusions:
- Adherence to recommended cystometrogram surveillance for neurogenic bladder in suprasacral spinal cord injury remains low.
- Veterans receiving cystometrograms demonstrated lower mortality risk over two decades.
- Findings suggest a re-evaluation of strategies to enhance adherence to neurogenic bladder surveillance protocols.
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