INTRODUCTION

Significance of neuropathic lower urinary dysfunction in the SCI patients

  • People with SCI have an increased risk of urological complications.
  • During WWI, about 80% of SCI patients died of PN [Kennedy 1946].
  • Mortality rates for SCI patients have declined dramatically since World War II.
  • However, even though life expectancy has improved during the past few decades, people with SCI continue to experience diminished life expectancy compared with their non disabled peers [Krause 2004]  
  • Despite improved methods of treatment, urinary tract morbidity still ranks as the second leading cause of death in the SCI patient [Siroky 2002] and the quality of life is severely damaged by urinary incontinence.

Current Problems in the diagnosis and management of the SCI patients

  • There is a need for more understanding.
  • Many management options are available.
  • Despite years of progress in this area beginning with intermittent catheterization at Stoke- Mandeville, sphinterotomy in England, attainment of a catheter free state at Long Beach, and the work of Lapides on management of the neurogenic bladder by control of pressure and CIC, patients continue to be treated in ways that allow development of serious and life threatening complications most if not all, of which are avoidable.

 

 

References

  • Kennedy RH, The new viewpoint toward spinal cord injuries. Ann Surg 1946; 124:1057-65.
  • Krause JS, Devivo MJ, Jackson AB. Health status, community integration, and economic risk factors for mortality after spinal cord injury. Arch Phys Med Rehabil. 2004 Nov;85(11):1764-73.  
  • Siroky MB. Pathogenesis of bacteriuria and infection in the spinal cord injured patient. Am J Med. 2002 Jul 8;113 Suppl 1A:67S-79S.

 

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