Urological Management and Long-Term Complications in Patients with Spinal Cord Injury and Neurogenic Lower Urinary Tract Dysfunction in Thailand: A Retrospective Study
Keywords:
neurogenic lower urinary tract dysfunction, neurogenic bladder, spinal cord injury, rehabilitation, complicationsAbstract
Objectives: To describe urological assessment, management and long-term complications in patients with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD) in Thailand.
Study design: Retrospective study.
Setting: Two university hospitals and three A-level hospitals in Thailand.
Subjects: Patients with SCI and NLUTD.
Methods: Medical records of patients with traumatic and non-traumatic SCI and NLUTD from five tertiary/A-level hospitals were obtained and manually reviewed to evaluate urological assessment, management and related complications. Descriptive statistics were used for the evaluation.
Results: Among the 5,822 medical records retrieved, 1,066 cases had been diagnosed with SCI and NLUTD. In the initial NLUTD assessment, it was found that 51.9% of the patients had undergone urodynamic study (UDS). The last bladder emptying techniques included indwelling transurethral catheter (38%), reflex voiding (30.1%), and self-catheterization (clean intermittent catherization) (20.3%). Approximately 40% of patients had had no regular urological follow-up. Among the 760 patients who had undergone imaging, 36.9% had upper urinary tract complications. There were significant differences between the university hospitals and the Ministry of Public Health hospitals in terms of urological assessment, management and follow-up protocol.
Conclusions: There were differences in methods of initial assessment, management, and surveillance follow-up protocol for SCI and NLUTD patients in university hospitals and those in MOPH hospitals in Thailand. Among the patients who underwent surveillance and investigation, a substantial number were found to have upper urinary tract complications.
Keywords: neurogenic lower urinary tract dysfunction, neurogenic bladder, spinal cord injury, rehabilitation, complications
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