Bladder management in individuals with spinal cord injury or disease during and after primary rehabilitation: a retrospective cohort study.

Krebs, Jörg; Wöllner, Jens; Rademacher, Franziska; Pannek, Jürgen (2022). Bladder management in individuals with spinal cord injury or disease during and after primary rehabilitation: a retrospective cohort study. World journal of urology, 40(7), pp. 1737-1742. Springer 10.1007/s00345-022-04027-x

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PURPOSE

The purpose of this study was to investigate the course of bladder evacuation and the predictors of intermittent self-catheterization (ISC) in individuals with neurogenic lower urinary tract dysfunction (NLUTD) during and after primary rehabilitation.

METHODS

The patient database of a single spinal cord injury rehabilitation center was screened for patients with NLUTD admitted for primary rehabilitation. Patient characteristics and bladder evacuation details were collected during and after rehabilitation. Binary logistic regression analysis was used to evaluate predictors of ISC: sex, age > 65 years, injury severity, and bladder capacity ≥ 400 ml.

RESULTS

Data of 255 men (74.3%) and 88 women (25.7%) with a mean age of 54 ± 19 years were analyzed. Early in rehabilitation, 21.6% of the evaluated individuals used ISC. In 17.8%, the bladder was evacuated by transurethral catheterization (TUC). The proportion of TUC decreased during rehabilitation and dropped below 2% at the last follow-up. In contrast, the proportion of ISC and suprapubic catheterization (SPC) increased to 28% and 12.8%, respectively, during rehabilitation. These proportions increased further thereafter and reached 37.7% and 18.6% for ISC and SPC, respectively. Age and injury severity were significant (p ≤ 0.041) negative predictors, whereas male sex and above-average bladder capacity were positive predictors of ISC.

CONCLUSIONS

There is a shift toward bladder evacuation by ISC and SPC during and after primary rehabilitation. Bladder evacuation by ISC, regarded as the gold standard, is less common in individuals > 65 years or with high-level tetraplegia. The optimal bladder evacuation method needs to be established individually, considering all medical and psychosocial factors rather than simply following a guideline.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Pannek, Jürgen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1433-8726

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

24 May 2022 13:56

Last Modified:

05 Dec 2022 16:20

Publisher DOI:

10.1007/s00345-022-04027-x

PubMed ID:

35599284

Uncontrolled Keywords:

Assisted intermittent catheterization Bladder management Indwelling catheterization Intermittent catheterization Intermittent self-catheterization Neurogenic lower urinary tract dysfunction Spinal cord injury Suprapubic catheterization Transurethral catheterization

BORIS DOI:

10.48350/170214

URI:

https://boris.unibe.ch/id/eprint/170214

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