THE UPPER URINARY TRACTS IN THE PARAPLEGIC: A LONG‐TERM SURVEY¹

Intermittent catheterisation: follow-up studies

“…Gibbon and co-workers (1969) reported a 10 per cent prevalence rate of hydronephrosis. In comparison, earlier reports in patients managed mainly with indwelling urethral catheters indicated hydronephrosis occurred in 20 to 43 per cent of spinal cord injured patients (Comarr, 1954;Damanski & Gibbon, 1956;Talbot et al, 1959;Ascoli, 1968 The difference in the prevalence of hydronephrosis between patients treated with immediate intermittent catheterisation and those maintained on indwelling catheters has led to the acceptance of intermittent catheterisation as the preferred method of bladder management. It was assumed the above results obtained with immediate intermittent catheterisation could be duplicated in patients who were treated initially with indwelling urethral catheters and intermittent catheterisation was used subsequently to achieve a catheter-free state.…”

“…Patients with incomplete injuries had changes in 29 per cent and 23 per cent for the right and left kidneys, respectively. Damanski and Gibbon (1956) noted reflux occurring more often on the right than the left side. Price (1976) studied the bacteriology of the upper urinary tract at the time of uretero-ileostomy and found positive cultures more frequently on the right side.…”

Ureteric reflux in the paraplegic

“…It will be seen from (Damanski and Gibbon, 1956), reflux is more frequently encountered in high than in low spinal injuries. This fact has also been commented on by others, notably Bors and Comarr (1952).…”

Managing the urinary tract in spinal cord injury

“…[58] Renal surveillance and improved lower urinary tract and general management have all contributed to greatly reduced rates of renal impairment in the SCI population. Despite the improvements, SCI patients continue to demonstrate an effect of their injury on renal integrity, especially as length of follow up increases.…”