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

Abstract

Study design: Retrospective chart review. Objectives: To document urinary tract abnormalities (UTAs) in patients with spinal cord injury (SCI) and to assess demographic and clinical features associated with UTA detected via ultrasound (US). Setting: Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. Methods: The medical and radiological records of all patients with SCI were screened. Variables in each patient with SCI, including age at the time of the US examination, gender, etiology, level and severity of SCI, time since injury, bladder management methods and findings of urinary tract US, were reviewed and analyzed. Results: Data were obtained from 1005 patients during the 6-year study period (2008)(2009)(2010)(2011)(2012)(2013). The mean age was 35.67 ± 14.79 years and the male-female ratio was 2.84:1. Trabeculated bladder (TB) was observed in 35.1% of the patients, bladder calculi in 6%, renal calculi in 6%, hydronephrosis in 5.5% and renal atrophy in 1.2%. Bladder calculi, renal calculi and renal atrophy were observed in patients with TB at higher rates than in those without TB (P = 0.001, 0.036 and 0.004, respectively). The association of TB with hydronephrosis was very close to significance level (P = 0.052). Conclusion: A large number of SCI patients had UTAs including TB, renal and bladder calculi, hydronephrosis and renal atrophy. The time since injury, level and severity of SCI and bladder management method may influence development of UTA. In addition, TB may be a helpful parameter for predicting UTA in SCI patients.

The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Diagnosis and Evaluation

“…Indwelling catheters increases the risk of UTIs 23 and is a source of chronic bacteriuria, both of which are risk factors for bladder and upper tract calculi. Bladder stones prevalence ranges from 8% to 41% 20,23–26 in patients with indwelling catheters and can go undetected without imaging until they are very large. The advantage of detecting stones when small is that they can be irrigated in clinic, while those that are slightly larger can be managed with a simple cystolitholapaxy.…”

“…Upper tract stones are also common in this patient population occurring in 6-32% of patients. 23,24,26 For this reason, renal and bladder ultrasound are required in moderate-or high-risk NLUTD patients with an indwelling catheter.…”

Incidental findings on prostate MRI: a close look at the field of view in this anatomical region

“…Overactivity of the detrusor muscle causes sustained high-bladder pressure, urinary incontinence, or sphincter-detrusor muscle dyssynergia and gives rise to the loss of bladder function coordination (33). Bladder trabeculation is one of the expected morphological and radiological changes in patients with a neurogenic bladder (34). Other morphological changes, such as wall thickening and a small-contracted or large-atonic bladder, are observed.…”