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World Journal of Urology

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01-10-2018 | Topic Paper

Early urological care of patients with spinal cord injury

Authors: Blayne Welk, Marc P. Schneider, Jeffrey Thavaseelan, Luca R. Traini, Armin Curt, Thomas M. Kessler

Published in: World Journal of Urology | Issue 10/2018

Abstract

Purpose

After spinal cord injury (SCI), the initial goals of urological management include maintaining safe storage of urine with efficient bladder emptying, maximising urinary continence, and minimising the risk of urological complications.

Methods

This review was performed according to the methodology recommended by the Joint SIU-ICUD International Consultation. Embase and Medline databases were used to identify literature relevant to the early urological care of SCI patients. Recommendations were developed by consensus and graded using a modified Oxford system which identifies level of evidence (LOE) and grade of recommendation (GOR).

Results

Clinicians must ensure appropriate bladder emptying immediately after SCI (LOE 3, GOR A) and perform the initial neuro-urological assessment within 3 months after injury (LOE 3, GOR A), including history, validated questionnaires, bladder diary, physical examination, measurement of renal function, and urinary tract imaging (LOE 4, GOR B). Urodynamics, if available video-urodynamics, must be performed to detect and specify lower urinary tract dysfunction (LOE 1, GOR A). Spontaneous voiding and/or intermittent catheterization must be considered in appropriate patients once they are medically stable (LOE 3, GOR A). Antimuscarinics are the first-line and intradetrusor botulinum toxin A injections are the second-line treatment for neurogenic detrusor overactivity (LOE 1, GOR A). Irreversible surgical interventions should be delayed until the second year after injury due to the potential for neurological recovery (LOE 4, GOR B).

Conclusions

Careful clinical assessment and pertinent urological testing including urodynamic investigation are necessary for appropriate counselling and treatment of new SCI patients.

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Title: Early urological care of patients with spinal cord injury
Authors: Blayne Welk
Marc P. Schneider
Jeffrey Thavaseelan
Luca R. Traini
Armin Curt
Thomas M. Kessler
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 10/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2367-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early urological care of patients with spinal cord injury

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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