Complication rate of neurogenic lower urinary tract dysfunction after spinal cord injury in Taiwan

Int Urol Nephrol. 2014 Jun;46(6):1063-71. doi: 10.1007/s11255-013-0625-6. Epub 2013 Dec 18.

Abstract

Purpose: In view of the limited information on neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI) in the literature, this study aimed to investigate the complication rate of NLUTD after SCI and to describe the clinical management of NLUTD in Taiwan.

Methods: A cross-sectional study was conducted using the National Health Insurance Research Database of Taiwan from which patients newly diagnosed with SCI during 2006-2008 were extracted. Records of diagnosis, prescriptions, and procedures for patients were retrieved to identify NLUTD cases. The utilization of medical treatments including pharmacotherapy and procedures such as intermittent and indwelling catheters was analyzed.

Results: A total of 941 eligible SCI patients were identified, with a mean age of 48.4 (±18.5), of which 575 (61.1 %) were male, and 500 (53.1 %) were with cervical SCI. By the end of 1-year follow-up, 165 (17.5 %) had developed NLUTD. The characteristics were mostly similar between the NLUTD and non-NLUTD groups except in age and length of stay (LOS) in hospitals, where patients with NLUTD were 7.5 years old and had 2.15-month-longer LOS. Over 80 % of NLUTD patients received urinary catheterization, with approximately half also receiving pharmacotherapy.

Conclusions: This is the first study using nationwide datasets to evaluate the overall complication rate of NLUTD associated with SCI, which is shown to be lower than previously reported. While various treatment options are available, urinary catheterization is the most common treatment for NLUTD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use
  • Adult
  • Age Factors
  • Aged
  • Catheters, Indwelling
  • Cholinergic Agonists / therapeutic use
  • Cholinergic Antagonists / therapeutic use
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intermittent Urethral Catheterization
  • Length of Stay
  • Male
  • Middle Aged
  • Risk Factors
  • Spinal Cord Injuries / complications*
  • Taiwan
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / therapy*
  • Urination Disorders / etiology
  • Urination Disorders / therapy*
  • Young Adult

Substances

  • Adrenergic alpha-Antagonists
  • Cholinergic Agonists
  • Cholinergic Antagonists