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Prospective evaluation of urological effects of aging in chronic spinal cord injury by method of bladder management

Lookup NU author(s): Marcus Drake

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Abstract

Aims: Risk of treatment-related problems in spinal cord injury (SCI) mandates assessment of complication rates of different bladder management methods (BMMs). The current study evaluated aging-related complications of various BMMs over a 6-year period in a population with spinal cord injury for at least 20 years. Materials and Methods: Clinical parameters were compared using a linear mixed effects model, controlling for various confounding variables, to establish complication trends with aging and their association with BMM. Results for people whose BMM was changed during the study were evaluated separately as well as in combination with the whole population. Results: One hundred and ninety six people (mean age 57.4 and years post injury (YPI) 33) were evaluated on three occasions. Both age and YPI were significantly associated with rising complication rates regardless of BMM. The BMMs assessed differed in terms of complication rates. In comparison with balanced reflex voiding, straining was significantly better for renal structural abnormality. Intermittent catheterization was associated with significantly worse renal function, possibly for demographic reasons. Overall, 28.8% changed BMM during the study period, particularly, those using straining or balanced reflex voiding. The probability of change increased with age and YPI. Reasons for change of BMM were varied and there was no specific association between reason for change and BMM. Conclusions: Aging and duration of injury substantially influence urological complication rates, and BMM options differ in respect of prevalence and incidence of complications. At a late stage post injury there remains a high probability of change in BMM. The findings indicate the importance of long-term planning from the time of injury to minimize late complications. © 2004 Wiley-Liss, Inc.

Publication metadata

Author(s): Drake MJ, Cortina-Borja M, Savic G, Charlifue SW, Gardner BP

Publication type: Article

Publication status: Published

Journal: Neurourology and Urodynamics

Year: 2005

Volume: 24

Issue: 2

Pages: 111-116

Print publication date: 01/01/2005

ISSN (print): 0733-2467

ISSN (electronic): 1520-6777

Publisher: Wiley-Liss, Inc

URL: http://dx.doi.org/10.1002/nau.20091

DOI: 10.1002/nau.20091

PubMed id: 15605371

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