Silent hydronephrosis, a hazard revisited

Rosen, Joel S.; Nanninga, John B.; O’Conor, Vincent J.

doi:10.1038/sc.1976.21

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…The major goal of any longterm surveillance programme is the early detection of these complications so that evaluation and intervention might prevent subsequent renal damage. To achieve this, most spinal cord centres now attempt to maintain patients in a catheter-free state (Graham,19Sl), though upper tract changes can occur even when the patient is on intermittent catheterisation or condom catheter drainage (Rosen et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

Prediction of Pyelocaliectasis in Follow‐up of Patients with Spinal Cord Injury

Lloyd

Kuhlemeier

Fine

et al. 1987

British Journal of Urology

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Two hundred and fifty spinal cord injury patients were studied on each of two occasions, 12 to 24 months apart, to determine which urological findings could be used to predict the subsequent development of clinically significant pyelocaliectasis. An equation was developed which correctly classified 90% of the patients who remained free of clinically significant pyelocaliectasis and 82% of the patients who subsequently developed clinically significant pyelocaliectasis. The statistically significant risk factors were renal calculi, bladder diverticula and a decrease in effective renal plasma flow. This study suggests that the presence of these risk factors warrants careful monitoring of renal function in these patients and appropriate management of bladder dysfunction.

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Section: Discussionmentioning

confidence: 99%

Prediction of Pyelocaliectasis in Follow‐up of Patients with Spinal Cord Injury

Lloyd

Kuhlemeier

Fine

et al. 1987

British Journal of Urology

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“…Conclusions of this study are applicable only to asymptomatic spinal cord injury patients who come for routine annual follow-up. Health professionals should remember that patients with spinal cord injury may develop hydronephrosis silently [9]. For example, after an apparently successful trial of micturition, some patients may retain progressively increasing volumes of urine in the bladder over a period.…”

Section: Study Limitationsmentioning

confidence: 99%

A Comparative Study of Ultrasound Examination of Urinary Tract Performed on Spinal Cord Injury Patients with No Urinary Symptoms and Spinal Cord Injury Patients with Symptoms Related to Urinary Tract: Do Findings of Ultrasound Examination Lead to Changes in Clinical Management?

Vaidyanathan

Hughes

Soni

2006

The Scientific World JOURNAL

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Findings of ultrasound examination of the urinary tract and changes in clinical management, which were instituted on the basis of ultrasound examination, were compared between two groups of spinal cord injury patients. Group 1 had no urinary symptoms when they underwent the scan, whereas group 2 was comprised of patients with symptoms pertaining to the urinary tract. Between 2000 and 2006, ultrasound examination of the urinary tract was performed in 87 spinal cord injury patients who had no urinary symptoms when they underwent the ultrasound scan. No abnormality was found in 63 patients. The ultrasound scan showed some abnormality of the urinary tract in 24 patients (simple cyst in the kidney: 4; reduced size of a kidney: 3; increased echogenicity of left kidney: 1; prominent extrarenal pelvis and mild calyceal dilatation: 1; slightly dilated renal pelvis and calyceal system: 1; pelvic kidney showing mild hydronephrosis: 1; foetal lobulation of kidney: 2; multicystic kidney with no interval change in the appearance since last examination: 1; 2-cm-diameter parapelvic cyst: 1; small renal calyceal calculus: 5; a little cortical scarring bilaterally: 1; focal renal scar: 2; generalised thinning of renal cortex: 3; increase in renal sinus fat: 3; trabeculated bladder: 2; small vesical diverticulum: 1; mild generalised bladder wall thickening: 1; small residual urine in postvoid scan; 2). No specific interventions were performed in these patients on the basis of ultrasound findings. In Group 2, ultrasound examination revealed serious abnormalities such as hydronephrosis, pyonephrosis, vesical calculi, vesical polyp in 20 of 21 patients, and all 20 patients required therapeutic intervention on the basis of ultrasound scan findings.In conclusion, routine ultrasound examination of the urinary tract in spinal cord injury patients who have no urinary symptoms may not be justifiable in terms of cost effectiveness; limited hospital resources should be directed to spinal cord injury patients with urinary symptoms so that ultrasound examination and therapeutic interventions based on ultrasound findings are carried out expeditiously.

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“…[2]. Rosen and associates [3] recommend that all spinal cord injury patients functioning in the catheter-free state must be followed regularly at no longer than 6-month intervals. Changes in the resistance to the outflow of urine may occur at any time, even years after injury.…”

Section: Introductionmentioning

confidence: 99%

Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication

et al. 2012

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BackgroundCondom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications.Case reportA 32-year old, male person, sustained complete paraplegia at T-11 level in 1985. He had been using condom catheter. Eleven years after sustaining spinal injury, intravenous urography showed no radio-opaque calculus, normal appearances of kidneys, ureters and bladder. Blood urea and Creatinine were within reference range. A year later, urodynamics revealed detrusor pressure of 100 cm water when detrusor contraction was initiated by suprapubic tapping. This patient was advised intermittent catheterisation and take anti-cholinergic drug orally; but, he wished to continue penile sheath drainage. Nine years later, this patient developed bilateral hydronephrosis and renal failure. Indwelling urethral catheter drainage was established. Five months later, ultrasound examination of urinary tract revealed normal kidneys with no evidence of hydronephrosis.ConclusionSpinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure. Intermittent catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder.

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Silent hydronephrosis, a hazard revisited

Cited by 12 publications

References 7 publications

Prediction of Pyelocaliectasis in Follow‐up of Patients with Spinal Cord Injury

Prediction of Pyelocaliectasis in Follow‐up of Patients with Spinal Cord Injury

A Comparative Study of Ultrasound Examination of Urinary Tract Performed on Spinal Cord Injury Patients with No Urinary Symptoms and Spinal Cord Injury Patients with Symptoms Related to Urinary Tract: Do Findings of Ultrasound Examination Lead to Changes in Clinical Management?

Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication

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