Non-surgical urologic management of neurogenic bladder after spinal cord injury

Romo, Paholo G. Barboglio; Smith, Christopher P.; Cox, Ashley; Averbeck, Márcio Augusto; Dowling, Caroline; Beckford, Cleveland; Manohar, Paul; Durán, Sergio López; Cameron, Anne P.

doi:10.1007/s00345-018-2419-z

Cited by 76 publications

(63 citation statements)

References 72 publications

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“…CIC is the gold standard of urinary management in SCI patients who cannot be permitted to void due to a significant risk of damage to the urinary tract ( LoE 4, GoR B ) . When a patient has risk factors for renal damage (upper urinary tract deterioration or renal impairment), CIC should be initiated as soon as possible.…”

Section: Summary Of the Guidelinesmentioning

confidence: 99%

“…CIC: CIC is the gold standard of urinary management in SCI patients who cannot be permitted to void due to a significant risk of damage to the urinary tract (LoE 4, GoR B). 21 When a patient has risk factors for renal damage (upper urinary tract deterioration or renal impairment), CIC should be initiated as soon as possible. Proper education and instruction with adequate follow up are of paramount importance in the long-term compliance and persistence of CIC, as well as avoiding complications, such as urethral trauma and stricture in male patients, gross hematuria, and symptomatic UTI.…”

Section: -3 Voidingmentioning

confidence: 99%

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Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

et al. 2020

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The present article is an abridged English translation of the Japanese clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury updated as of July 2019. The patients are adult spinal cord injured patients with lower urinary tract dysfunction; special consideration of pediatric and elderly populations is presented separately. The target audience is healthcare providers who are engaged in the medical care of patients with spinal cord injury. The mandatory assessment includes medical history, physical examination, frequency‐volume chart, urinalysis, blood chemistry, transabdominal ultrasonography, measurement of post‐void residual urine, uroflowmetry and video‐urodynamic study. Optional assessments include questionnaires on the quality of life, renal scintigraphy and cystourethroscopy. The presence or absence of risk factors for renal damage and symptomatic urinary tract infection affects urinary management, as well as pharmacological treatments. Further treatment is recommended if the maximum conservative treatment fails to improve or prevent renal damage and symptomatic urinary tract infection. In addition, management of urinary incontinence should be considered individually in patients with risk factors for urinary incontinence and decreased quality of life.

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Section: Summary Of the Guidelinesmentioning

confidence: 99%

Section: -3 Voidingmentioning

confidence: 99%

Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

et al. 2020

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“…Management of neurogenic bladders entails six approaches: (a) intermittent bladder catheterization; (b) indwelling catheters; (c) condom catheter drainage; (d) reflex voiding and bladder expression with Valsalva or Credé; (e) oral drug therapy, and (f) botulinum neurotoxin. Currently, the management of neurogenic bladder is focused on improving quality of life and preserving renal function (Romo et al, ). Non‐invasive medical management is key to both improve urodynamic parameters of bladder capacity and decrease detrusor pressure, as well as improve quality of life outcomes with neurogenic bladder management in patients with spinal cord injury (Romo et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the management of neurogenic bladder is focused on improving quality of life and preserving renal function (Romo et al, ). Non‐invasive medical management is key to both improve urodynamic parameters of bladder capacity and decrease detrusor pressure, as well as improve quality of life outcomes with neurogenic bladder management in patients with spinal cord injury (Romo et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, considerable morbidity (20%-80%) with upper urinary tract damage (UUTD) has been reported for patients with a neurogenic bladder in a variety of studies (Groen et al, 2016). These patients suffer from various types of UUTD, such as vesicoureteral reflux (VUR), ureteral dilatation, pyelonephritis, and hydronephrosis (Groen et al, 2016), all of which could lead to renal failure and even death (Şekerci et al, 2014) (Romo et al, 2018). Non-invasive medical management is key to both improve urodynamic parameters of bladder capacity and decrease detrusor pressure, as well as improve quality of life outcomes with neurogenic bladder management in patients with spinal cord injury (Romo et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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A nonsurgical and nonpharmacological care bundle for preventing upper urinary tract damage in patients with spinal cord injury and neurogenic bladder

Fang

Lin

Liu

et al. 2019

Int J of Nursing Practice

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Aim To establish a care bundle in spinal cord injury patients with neurogenic bladder to avoid upper urinary tract damage and to provide guidance for health care staff in use of nonsurgical and nonpharmacological adjunctive strategies to improve patients' clinical outcomes. Background Prevention of upper urinary tract damage is critical in the management of spinal cord injury patients with a neurogenic bladder, but there are no authoritative guidelines or high‐quality randomized controlled trials. Design The study was conducted on the basis of Fulbrook and Mooney's seven‐step method for care bundle development. Data Sources The databases PubMed, Embase, Science Citation Index, the Cumulative Index to Nursing and Allied Health Literature, the National Guideline Clearinghouse, the Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, and China Dissertation Database were searched from the date of each database's inception to April 2017. Review methods We evaluated the literature according to the Joanna Briggs Institute evidence pre‐ranking and grade recommendation system (2014 version). The results were examined using a self‐designed data extraction. Results A three‐element cluster including clean intermittent catheterization, bladder function training, and transcutaneous low‐frequency pulsed electrical stimulation was formed. Conclusion The development of this bundle can provide a scientific basis for effective prevention of neurogenic upper urinary tract damage in clinical practice.

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Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robotic approaches

Haudebert

Hascoët

Freton

et al. 2021

Neurourology and Urodynamics

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Aim:The objective of the present study was to compare the outcomes of open versus laparoscopic versus robotic cystectomy and ileal conduit for neurogenic lower urinary tract dysfunction (NLUTD). Methods: The charts of all patients who underwent cystectomy and ileal conduit for NLUTD between January 2004 and November 2020 in an academic center were retrospectively reviewed. The approach was either open, laparoscopic or robot-assisted depending on the period (i.e., three consecutive era).For the robotic approach, the diversion was done either intracorporeally or extracorporeally. We compared the perioperative and late postoperative outcomes between the three groups. Results: After exclusion of 10 patients with non-neurogenic benign conditions, 126 patients were included over the study period. The most frequent neurological conditions were multiple sclerosis (36.5%) and spinal cord injury (25.4%). The approach was open, laparoscopic or robot-assisted in 31 (24.6%), 26 (20.6%) and 69 (54.7%) cases respectively. Seventy-two patients experienced a 90-day postoperative complication (57.1%) of which 22 had a major complication (Clavien 3 or higher, 17.5%) including one death (0.8%). The rate of major postoperative complications was significantly lower in the robotic group (23% vs. 23% vs. 10%; p = 0.049) while the rate of overall complications was comparable across the three groups (58.1% vs. 53.9% vs. 60.6%; p = 0.84). After a median follow-up of 23 months, 22 patients presented a late complication (17.6%), mainly incisional hernia (5; 4%) and uretero-ileal stricture (9; 7.2%). The rate of late complications did not differ significantly between the three approaches. Conclusion:Cystectomy and ileal conduit for neurogenic bladder is associated with a relatively high perioperative morbidity. The robot-assisted approach may decrease the risk of major postoperative complications.

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Non-surgical urologic management of neurogenic bladder after spinal cord injury

Cited by 76 publications

References 72 publications

Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury

A nonsurgical and nonpharmacological care bundle for preventing upper urinary tract damage in patients with spinal cord injury and neurogenic bladder

Cystectomy and ileal conduit for neurogenic bladder: Comparison of the open, laparoscopic and robotic approaches

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