Lower urinary changes over time in suprasacral spinal cord injury

Area of Science:

• Urology
• Neurology
• Rehabilitation Medicine

Background:

• Suprasacral spinal cord injury (SCI) can lead to significant bladder dysfunction.
• Management of bladder function in SCI patients is crucial for long-term health and quality of life.

Purpose of the Study:

• To investigate the relationship between bladder management methods, age, time since injury, and urodynamic parameters in suprasacral SCI patients.
• To compare maximum detrusor pressure, compliance, and bladder trabeculation across different bladder management strategies.

Main Methods:

• Retrospective review of 179 suprasacral SCI patients undergoing videourodynamic evaluation.
• Patients categorized into four bladder management groups: clean intermittent catheterization (CIC), indwelling catheter (IND), external collector (EC), and voiding (V).
• Analysis of maximum detrusor pressure, compliance, and trabeculation in relation to age and years post-injury.

Main Results:

• Maximum detrusor pressure decreased with age in EC and CIC groups, and with years post-injury in the EC group.
• Detrusor pressure was highest in the first decade post-injury and decreased thereafter for EC users.
• More severe bladder trabeculation was observed in the EC group compared to CIC and IND groups.

Conclusions:

• Long-standing suprasacral SCI patients using EC may exhibit lower detrusor pressures, possibly influenced by aging and prior high pressures.
• Reduced survival in EC users with chronically elevated detrusor pressure might be a factor.
• Bladder management strategies significantly impact urodynamic outcomes in SCI patients over time.