Association of stone surgery with patient‐reported complications after spinal cord injury

Abstract

Aims To determine if a history of urinary stone surgery in individuals with spinal cord injury (SCI) is associated with an increased incidence of SCI‐related complications and lower quality of life (QOL). Methods The Neurogenic Bladder Research Group (NBRG) registry is a multicenter, prospective, observational study which measures QOL after acquired SCI. Over 1.5 years, 1479 participants were enrolled and grouped according to history of stone surgery. We evaluated SCI‐related complications, QOL, and associations between patient factors and prior stone surgery using multivariable regression. Results Participants were a median of 11 years post‐SCI and 189 (12.8%) reported prior bladder or kidney stone surgery; 95.8% of these occurred after the SCI. Median time between SCI and first stone was 5.6 years (IQR: 1.8–12.8). Hospitalizations were higher for those with prior stone surgery, with common reasons including UTIs, blood clots, pressure ulcers, and pneumonia (p < 0.001). During the year of observation, the incidence of stone surgery was 17% in those with a prior history of stone surgery and 2% per year in those without prior stone surgery (p < 0.001). Controlling for covariates, bladder management strategy, age, BMI, and years since SCI were associated with history of stone surgery. Conclusions People with SCI and a history of surgical stone disease are at high risk for episodes of recurrent stones and increased hospitalizations, particularly those with kidney stones and indwelling catheter use. Identification of high‐risk patients may guide tailored surveillance for complications and stone prevention strategies.

Sex Differences in Bladder Management, Symptoms, and Satisfaction After Spinal Cord Injury

“…Maybe this has to do with the much higher rate of bladder complications and UTI incidence, which has well-established increased rates with IDCs. 26-28 In fact, it is very important to note that while our study establishes that IDC’s are associated with fewer bladder symptoms, compared to CIC, the negative health-related morbidity of IDCs should remain a very important point of discussion in shared decision-making.…”

Risk factors of bladder stones in neurogenic lower urinary tract dysfunction: A real‐world study

“…Owing to the underlying neurological diseases, patients experience more complex challenges in the diagnosis and treatment of urinary stones compared with the general population. In addition, bladder stones tend to recur more frequently and lead to increased morbidity in NLUTD patients 5 . Therefore, patients with NLUTD should be monitored closely for bladder stones.…”

“…In addition, bladder stones tend to recur more frequently and lead to increased morbidity in NLUTD patients. 5 Therefore, patients with NLUTD should be monitored closely for bladder stones.…”