Article

A systematic literature review.Objectives:To systematically assess
the existing knowledge about treatment of neurogenic lower urinary tract
dysfunction (NLUTD) in pregnant women with traumatic spinal cord injury (SCI), as
urologic management of these patients is mandatory,
but no guidelines are
available.Setting:Paraplegic center in Switzerland.Methods:Studies were
identified by electronic search of PubMed and MedLine. Data were pooled and
analyzed quantitatively.Results:The evidence level of all 14 reports (163
patients, 226 pregnancies) included was low. In 13 studies, information was
gathered by a retrospective review of the medical records or by questionnaires.
In all studies, reported data were incomplete. SCI was cervical in 34.7%,
thoracic in 61.2% and lumbar in 4.1% of the pregnant women. In all 34.7% of the
women used indwelling catheters, 25% performed intermittent catheterization,
11.5% used the Crede maneuver and 28.8% voided spontaneously. A total of 64% of
the patients had at least one symptomatic urinary tract infection (UTI) during
pregnancy. UTIs were more common in women with indwelling catheters (100%) than
in those performing intermittent catheterization (38.5%), using the Crede
technique (17%) or voiding spontaneously (53.3%). One study demonstrated a
significant reduction in UTI during pregnancy without complications in mothers or
infants.Conclusion:No evidence-based recommendations can be drawn from the
existing literature to guide urologists in the management of NLUTD in pregnant
women with SCI. The number of studies is small, and data acquisition and
presentation are often inadequate. Thus, further research is urgently needed.

Langue : ANGLAIS