Morbidity of urinary tract infection after urodynamic examination of hospitalized SCI patients: the impact of bladder management

Böthig, Ralf; Fiebag, Kai; Thietje, Roland; Faschingbauer, M.; Hirschfeld, Sven

doi:10.1038/sc.2012.107

Cited by 42 publications

(32 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Risk factors for UDS-related UTI have been reported previously, including diabetes, old age (>70 years), history of urination control surgery, indwelling catheterization, in addition to certain procedures such as tissue biopsy [8910], and neurogenic bladder in patients with SCI. In patients with SCI, bladder paralysis, unstable detrusor muscle activity, pyuria before a UDS, and the use of intermittent catheterization or reflex voiding have often been related to UTI occurrence [1112]. Therefore, physicians in many hospitals prescribe prophylactic antibiotics to patients with SCI to prevent UTI when they are going to perform a UDS.…”

Section: Introductionmentioning

confidence: 99%

Factors Related to the Occurrence of Urinary Tract Infection Following a Urodynamic Study in Patients With Spinal Cord Injury

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo analyze the factors related to urinary tract infection (UTI) occurrence after an urodynamic study (UDS) in patients with spinal cord injury (SCI).MethodsWe retrospectively investigated the medical records of 387 patients with SCI who underwent UDS with prophylactic antibiotic therapy between January 2012 and December 2012. Among them, 140 patients met the inclusion criteria and were divided into two groups, UTI and non-UTI. We statistically analyzed the following factors between the two groups: age, sex, level of injury, SCI duration, spinal cord independence measure, non-steroidal anti-inflammatory drug use, diabetes mellitus, the American Spinal Injury Association impairment scale (AIS), lower extremity spasticity, a history of UTI within the past 4 weeks prior to the UDS, symptoms and signs of neurogenic bladder, urination methods, symptoms during the UDS and UDS results.ResultsAmong the 140 study participants, the UTI group comprised 12 patients and the non-UTI group comprised 128 patients. On univariate analysis, a history of UTI within the past 4 weeks prior to the UDS was significant and previous autonomic dysreflexia before the UDS showed a greater tendency to influence the UTI group. Multivariable logistic regression analysis using these two variables showed that the former variable was significantly associated with UTI and the latter variable was not significantly associated with UTI.ConclusionIn patients with SCI, a history of UTI within the past 4 weeks prior to the UDS was a risk factor for UTI after the UDS accompanied by prophylactic antibiotic therapy. Therefore, more careful pre-treatment should be considered when these patients undergo a UDS.

show abstract

Section: Introductionmentioning

confidence: 99%

Factors Related to the Occurrence of Urinary Tract Infection Following a Urodynamic Study in Patients With Spinal Cord Injury

et al. 2016

View full text Add to dashboard Cite

show abstract

“…AD is commonly defined as an abrupt 20 to 40 mmHg rise in systolic blood pressure (SBP) above the baseline blood pressure with or without other symptoms[2]. Almost all SCI patients suffer from neurogenic lower urinary tract dysfunction (NLUTD) and therefore urodynamic study (UDS) is essential for these patients in order to assess the bladder function during their initial rehabilitation period and the following lifelong surveillance[3]. European Association of Urology guidelines on NLUTD also demonstrate grade A recommendation for the necessity of UDS to document the dysfunction of lower urinary tract[4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Autonomic Reactions during Urodynamic Examination in Patients with Spinal Cord Injuries and Able-Bodied Subjects

et al. 2016

View full text Add to dashboard Cite

Background/PurposeThis study compares heart rate variability (HRV) and systolic blood pressure (SBP) changes of spinal cord injury (SCI) patients during urodynamic study (UDS) with able-bodied controls.MethodsTwenty four complete suprasacral SCI patients (12 tetraplegia and 12 paraplegia) and 12 age-matched able-bodied volunteers received BP and HRV evaluation throughout urodynamic examination. We chose seven time points during the examinations: resting, Foley catheter insertion, start of infusion, and infused volume reaching 1/4, 2/4, 3/4 and 4/4 of maximal capacity. At each time point, electrocardiogram with a duration of 5 min was used for power spectral density analysis of HRV.ResultsOnly control subjects displayed significant elevation of SBP during Foley catheter insertion compared to resting values. Both control and tetraplegic groups experienced significant elevation of SBP at maximal bladder capacity compared to resting values. Tetraplegic values were also significantly greater than the other two groups. Control subjects displayed significant elevation of low frequency/high frequency (LF/HF) ratios during Foley catheter insertion and when approaching maximum bladder capacity. These findings were not seen in the paraplegic and tetraplegic groups. However, subgroup analysis of tetraplegic subjects with SBP elevation >50 mmHg demonstrated a similar LF/HF response to the able-bodied controls.ConclusionTetraplegic patients experienced BP elevation but did not experience significant changes in HRV during bladder distension. This finding may imply that different neurological pathways contribute to AD reaction and HRV changes during bladder distension. However, profound AD during UDS in tetraplegic patients was associated with corresponding changes in HRV. Whether HRV monitoring would be beneficial in SCI patients presenting with significant AD, it needs further studies to elucidate.

show abstract

“…Consultation with microbiology colleagues will be advantageous if establishing evidence-based local antibiotic guidelines for this patient group. 3,6,8 This topic remains controversial as the choice and use of prophylactic antibiotics are not well-defined. 9 There is a wide variation in practice surrounding the selection, use and timing of antibiotic prophylaxis for urodynamics.…”

Section: Discussionmentioning

confidence: 99%

“…Knowledge of local pathogen profiles, susceptibility and virulence is essential in establishing evidence-based local antibiotic guidelines for this patient group. 3,6,8 This topic remains controversial as the choice and use of prophylactic antibiotics are not welldefined. 9 There is the argument that clinically useful data should include an estimation of local infection rates through audit as well as knowledge regarding community antibacterial resistance levels to inform local practice.…”

mentioning

confidence: 99%

Antibiotic Use for Urodynamics: A Comprehensive Review that Informs Local Practice

Townsend

2016

Urology Practice

View full text Add to dashboard Cite

Introduction:The question is addressed of whether antibiotics should be given prophylactically to all patients undergoing urodynamic testing or targeted only to those considered at higher risk for urinary tract infection after the procedure. A PICOT (Population, Intervention, Comparison, Outcome, Time) question was formulated to ensure a successful search strategy. The clinical question aimed to address the issue of widespread use of antibiotic prophylaxis as this remains unclear in the literature.

show abstract

Morbidity of urinary tract infection after urodynamic examination of hospitalized SCI patients: the impact of bladder management

Cited by 42 publications

References 13 publications

Factors Related to the Occurrence of Urinary Tract Infection Following a Urodynamic Study in Patients With Spinal Cord Injury

Factors Related to the Occurrence of Urinary Tract Infection Following a Urodynamic Study in Patients With Spinal Cord Injury

Comparison of Autonomic Reactions during Urodynamic Examination in Patients with Spinal Cord Injuries and Able-Bodied Subjects

Antibiotic Use for Urodynamics: A Comprehensive Review that Informs Local Practice

Contact Info

Product

Resources

About