Urethral Complications in Spinal Cord Injury

Abstract

rethral complications are recognised in patients post spinal cord injury (SCI) and can be challenging to manage. Our aim was to review the literature to identify the aetiology, incidence, risk factors and management for urethral complications in spinal cord injured patients. METHODSA search was carried out using the PubMed database for peer reviewed articles on 01/01/18. The following search terms were used: "spinal cord injury", "cauda equina", "neuropathic bladder" "neurogenic bladder" and were combined with "urethral complications", "urethral stricture", "urethral di- J Reconstr Urol 2018;8(1):21-7 21Urethral Complications in Spinal Cord Injury A AB BS S T TR RA AC CT T Spinal cord injury may pose a difficulty for the bladder to empty efficiently. In this scenario catheters are utilised, either in the form of clean intermittent catheterisation (CIC) or indwelling catheters. Little has been collated in the literature regarding the urethral complications associated with these methods of bladder drainage. We reviewed the literature of the published articles reporting on the urethral complications associated with catheter use in the spinal cord injured population. Long term, both methods carry a risk of urethral complications including tructuring, erosion, fistulation and diverticulum formation with less risk reported for CIC. Although reports of the management of these complications are limited in the literature, surgical repair forms the mainstay of management and in severe cases urinary diversion is required.K Ke ey yw wo or rd ds s: : Urethral complications; urethral erosion; urethral diverticulum; urethral stricture; urethral fistula; spinal cord injuries; clean intermittent catheterisation Ö ÖZ ZE ET T Spinal kord yaralanması, mesanenin etkin boşaltılmasında önemli güçlük çıkarabilir. Bu durumda "clean intermittent" kateterler (CIC) ve/veya "indwelling" kateterler kullanılabilir. Bu metotlarla mesanenin boşaltılmasına ilişkin üretral komplikasyonları ele alan literatürü gözden geçirdik. Spinal kord hasarı yaşamış popülasyonda kateter kullanımına ilişkin üretral komplikasyonları ele alan makaleleri derledik. Uzun dönemde, her iki kateter yönteminde de sık rastlanan komplikasyonlar erozyon, fistülasyon ve divertikulum formasyonu olmakla beraber, bu riskler CIC ile daha az rapor edilmiştir. Bu komplikasyonların yönetimine ilişkin makalelerin raporların sayısı az olmakla birlikte, bunların tedavisinde ana yöntem cerrahi onarım olmaktadır. Şiddetli olgularda üriner diversiyon gerekmektedir.A An na ah h t ta ar r K Ke e l li i m me e l le