Which factors predict upper urinary tract deterioration in overactive neurogenic bladder dysfunction?

Özkan, Berna; Demi̇rkesen, Oktay; Durak, Haydar; Uygun, Nesrin; i̇Smai̇loğlu, Vasi̇f; Çeti̇nel, Bülent

doi:10.1016/j.urology.2005.02.009

Cited by 40 publications

(31 citation statements)

References 23 publications

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“…Larsen suggested that severe detrusor fibrosis histologically was likely a risk factor in UUT deterioration. 16 Sekar et al 5 noted that reduced renal function seems to be related to renal calculus. Our study also indicates that the relationship between bladder calculus and UUT still seems to be unclear.…”

Section: Discussionmentioning

confidence: 99%

Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a prospective study

Zhang

Liu

2014

Spinal Cord

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Study design: A prospective study. Objectives: To investigate the risk factors predicting upper urinary tract (UUT) deterioration in patients with spinal cord injury (SCI). Setting: Beijing, China. Methods: We reviewed the medical records and UUT imaging studies of 112 patients, with a mean follow-up of 2 years. Variables evaluated for possible influence on UUTs included patient age, gender and educational background; injury level and completeness; bladder management method; and the presence of adverse outcomes such as recurrent urinary tract infections and bladder stones. Video urodynamic data were also reviewed. Total renal function was assessed by serum creatinine. UUT abnormalities were assessed by renal ultrasound or magnetic resonance imaging. Results: Lumbosacral spinal cord lesions likely contribute to UUT deterioration. UUT abnormalities were present in 23 patients (65.7%) in a spontaneous voiding group, 10 patients (20%) in a clean intermittent catheterization group, 15 patients (78.9%) in an indwelling urethral catheterization group and 7 patients (87.5%) in a suprapubic Foley catheterization group (Po0.001). When dividing bladder management method into two groups, catheter-free (spontaneous and intermittent voiding) and indwelling catheter (urethral and suprapubic catheterization), there was UUT dysfunction in 33 patients (38.3%) and 22 patients (81.5%), respectively (Po0.001). INTRODUCTIONNeurogenic bladder is one of the bladder and/or urethral dysfunctions caused by nervous system disease, and spinal cord injury (SCI) is one of the most common causes. In the 1950s, 45-50% of patients with SCI died of renal failure and uremia secondary to SCI. 1 Neurogenic bladder management methods have changed enormously in the last 60 years, especially with the development of neurology and introduction of sterile or clean intermittent catheterization (IC); the morbidity of upper urinary tract (UUT) lesion has decreased to 3-5%, and the mortality caused by renal failure also decreased significantly. Nevertheless, many current studies indicate that urinary complications are still the main causes of death during the later stage in SCI. A recent large-scale epidemiological study in the United States showed that 29-36% of patients with SCI suffer from lower urinary tract infection. 2 Several factors associated with UUT deterioration in patients with SCI need further study: the risk factors contributing to UUT in patients with SCI should be identified early to allow for proper clinical intervention, protect UUT function, and improve patients' quality of life after injury.

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Section: Discussionmentioning

confidence: 99%

Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a prospective study

Zhang

Liu

2014

Spinal Cord

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“…This parameter is mostly replaced with the measurement of DLPP and pelvic floor electromyography in contemporary practice. DLPP and bladder compliance are the other parameters which have been shown to act as a predictive factor in myelodysplasia [2,5,22] . Findings in this study revealed that these factors were irrelevant to scar formation.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Renal Scar Development in Children with Spina Bifida

et al. 2007

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Background/Aims: Prevention of renal scarring is the main therapeutic goal in children with spina bifida. We aimed to determine factors affecting renal scar development in these patients. Materials and Methods: Records of 312 children admitted between 1994 and 2005 with spina bifida were reviewed. Age on admission, gender, presence of previous febrile urinary tract infections (UTIs), vesicoureteral reflux (VUR), and initial urodynamic findings were noted. Patients were grouped regarding presence/absence of renal scars on DMSA scans. χ² and Student’s t tests were used for statistical evaluation. Results: Seventy-two patients had renal scars on admission. Mean age was 4.62 ± 4.59 years for patients without renal scars and 6.35 ± 4.9 years for patients with scars. Male/female ratio was 1:1 in the scarless group and 1:2 in the group with scars. Previous febrile UTI was present in 11 of 240 scarless patients in contrast to 7 out of 72 patients in the scar group (p > 0.05). VUR was present in only 16.3% of cases without scars, whereas 36.1% of patients in the scar group had VUR. Detrusor overactivity and detrusor sphincter dyssynergia were observed in 67.1% of scarred patients, whereas this figure was 42.4% in the scarless group. The comparison of age on admission, gender, detrusor overactivity, and detrusor sphincter dyssynergia revealed significant differences between patients with and without renal scars. Conclusions: Late referral, female gender, overactive detrusor, and detrusor sphincter dyssynergia have detrimental effects on renal parenchymal function in spina bifida patients. Patient selection for aggressive treatment using these features may prevent renal parenchymal deterioration.

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“…7 From other urodynamic studies it was already known that elevated detrusor leak point pressure and bladder storage pressure are major risk factors for upper tract deterioration in patients with SCI. 8,9 de Seze et al 10 reviewed risk factors for upper tract urinary tract complications in patients with MS recently. Definite risk factors were MS duration >15 years, indwelling urinary catheter, detrusor overactivity and high detrusor pressures; probable risk factors included detrusor-sphincter dyssynergia, males and >50 years.…”

Section: This Is the First Survey Among Urologists On The Implementatmentioning

confidence: 99%

Management of neurogenic bladder patients in the Netherlands: do urologists follow guidelines?

Rikken

Blok

2008

Neurourology and Urodynamics

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Which factors predict upper urinary tract deterioration in overactive neurogenic bladder dysfunction?

Cited by 40 publications

References 23 publications

Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a prospective study

Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: a prospective study

Factors Affecting Renal Scar Development in Children with Spina Bifida

Management of neurogenic bladder patients in the Netherlands: do urologists follow guidelines?

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