Article

OBJECTIVES: Our aim was to
evaluate the treatment methods and follow-up of neurogenic bladder in patients
with traumatic spinal cord injury retrospectively using a questionnaire. SETTING:
Turkey. METHODS: Three hundred and thirty-seven patients who had spinal cord
injury for at least 2 years were enrolled from six centers in the neurogenic
bladder study group. They were asked to fill-out a questionnaire about treatments
they received and techniques they used for bladder management. RESULTS: The study
included 246 male and 91 female patients with a mean age of 42+/-14 years.
Intermittent catheterization (IC) was performed in 77.9% of the patients, 3.8%
had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6%
performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No
gender difference was found regarding the techniques used in bladder
rehabilitation (P>0.05). Overall, 63.2% of patients used anticholinergic drugs;
anticholinergic drug use was similar between genders (P>0.05). The most common
anticholinergic drug used was oxybutynin (40.3%), followed by trospium (32.6%),
tolterodine (19.3%) darifenacin (3.3%), propiverine (3.3%) and solifenacin
(1.1%). The specialties of the physicians who first prescribed the
anticholinergic drug were physiatrists (76.2%), urologists (22.1%) and
neurologists (1.7%). Only four patients had previously received injections of
botulinum-toxin-A into the detrusor muscle and three of them stated that their
symptoms showed improvement. Most of the patients (77%) had regular follow-up
examinations, including urine cultures, urinary system ultrasound and urodynamic
tests, when necessary; the reasons for not having regular control visits were
living distant from hospital (15.3%) and monetary problems (7.7%). Of the
patients, 42.7% did not experience urinary tract infections (UTI), 36.4% had
bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes
per year and 5% had 3 clinical UTIs. The clinical characteristics of patients
with and without UTI (at least one symptomatic UTI during 1 year) were similar
(P>0.05). The frequency of symptomatic UTI was similar in patients using
different bladder management techniques (P>0.05). CONCLUSION: The most frequently
used technique for bladder rehabilitation in patients with SCI was IC (77.9%). In
all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most
commonly used drug. Also, 77% of patients had regular control visits for
neurogenic bladder; 42.7% did not experience any UTIs.
CN - Neurogenic Bladder Turkish Research Group

Langue : ANGLAIS