Risk factors for urinary stone formation in men with spinal cord injury: a 17‐year follow‐up study

Abstract

stone was more common in patients injured when aged ≥ 24 years than in those injured when aged < 24 years (odds ratio 2.5; 95% confidence interval 1.1-5.7; P = 0.03). In another model, patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (4.1, 1.3-12.9; P = 0.016). Renal stone was more common for patients with urethral catheterization than for those voiding spontaneously (5.7, 1.3-24.6, P = 0.021) and for patients with bladder stone than for those without (4.7, 1.5-15.1; P = 0.01). CONCLUSIONInjury characteristics are important for the development of urinary stone in chronic traumatic spinal cord injury. In addition, the present findings suggest that in men who cannot use intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than urethral catheterization to avoid renal stone formation. KEYWORDSspinal cord injury, urinary catheterization, stone, neurogenic bladder OBJECTIVETo establish hazard ratios for risk of urinary stone formation in men with chronic spinal cord injury. PATIENTS AND METHODSIn all, 140 men injured before 1987 were eligible for this investigation and were followed yearly from January 1987 and December 2003. RESULTSOver the 17 years, 39 patients (28%) and 21 (15%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. In multivariate analysis, bladder

Ultrasound findings of the urinary tract in patients with spinal cord injury: a study of 1005 cases

“…The literature includes inconsistent findings concerning the effect of level and severity of SCI on urinary calculi formation, which complete and high level injuries have been found associated with urinary calculi in some studies. [10][11][12] In the present study, urinary calculi were more frequent in patients with tetraplegia than those with paraplegia. But, these associations remained non-significant in the logistic regression analysis.…”

“…8,15 Bartel et al 5 noted bladder calculi by IUC in 6.6% and by CIC in 2%. Chen et al 14 found that IUC was associated with a substantially greater risk of bladder calculi; however, Ku et al 12 did not show this relationship with bladder calculi. In the present study, bladder calculi was observed 3.8% in spontaneous/other, 6.1% in CIC and 9.3% in IUC, although renal calculi had similar incidence rates among bladder management methods.…”

“…3,7,10, 13 Chen et al 14,15 found a decreasing trend over the past few decades in bladder calculi, but not in renal calculi in SCI cases. A wide range of incidence of urinary calculi in SCI patients has been previously reported, with incidences of bladder and renal calculi ranging from 1.3 to 28 3,7,8,10,12,15 and 3.3 to 28, 5,12,14 respectively. This discrepancy might be due to differences in follow-up period and patient characteristics, including age, gender, etiology, injury level and severity, time since injury and bladder management methods.…”

“…5,12 Chen et al 14,15 reported that the Table 4 Logistic regression analysis of the predictors of urinary tract abnormalities Ultrasound findings of the urinary tract in SCI Ü Güzelküçük et al risk for bladder and renal calculi reached its peak during the first 3 months after SCI and decreased after the first year. In the current study, it was observed that the highest occurence of bladder calculi was during the first year after SCI.…”

“…[1][2][3] It is well known that patients with SCI have an increased risk of urinary calculi compared with the general population with a higher chance of recurrence. 5,[10][11][12] Calculi formation is likely multifactorial with multiple lithogenic factors. Risk factors in patients with SCI are as follows: recurrent urinary tract infections, high intravesical pressure and subsequent vesicoureteric reflux, hypercalciuria secondary to reduced mobility, metabolic disturbances and environmental factors.…”