Bladder Management and Risk of Bladder Stone Formation in Spinal Cord Injured Patients

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2003Bladder Management and Risk of Bladder Stone Formation in Spinal Cord Injured Patients J. ORD, D. LUNN, and J. REYNARD J. ORDJ. ORD , D. LUNND. LUNN , and J. REYNARDJ. REYNARD View All Author Informationhttps://doi.org/10.1097/01.ju.0000091780.59573.faAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined by statistical analysis whether method of management is associated with risk of bladder stone formation in spinal cord injured patients. Materials and Methods: A retrospective cohort study was performed of 457 patients admitted to Stoke Mandeville Hospital Spinal Injuries Center between 1985 and 1990 with more than 6 months of followup. Analysis included Cox regression and Poisson regression. Results: Relative to those patients treated with intermittent self-catheterization, the hazard ratio was 10.5 (p <0.0005, 95% confidence interval 4.0–27.5) for patients with suprapubic catheters and it was 12.8 (p <0.0005, 95% confidence interval 5.1–31.9) for those with indwelling urethral catheters. The absolute annual risk of stone formation in patients with a catheter was 4% compared with 0.2% for those on intermittent self-catheterization. However, having formed a stone, the risk of forming a subsequent stone quadrupled to 16% per year. Bladder stones were no more likely to form in patients with suprapubic catheters compared to those with indwelling urethral catheters (hazard ratio 1.2, p = 0.6). Conclusions: In spinal cord injured patients long-term catheterization is associated with a substantial increased risk of bladder stone formation. This increased risk occurs independently of age, sex and injury level. Degree of injury (complete or incomplete) was considered in the model. Catheter type (suprapubic or urethral) did not change this risk significantly if at all. References 1 : Intermittent catheterisation for bladder emptying in paraplegia. R Soc Med1947; 40: 219. Google Scholar 2 : Long-term survival in spinal cord injury: a fifty year investigation. Spinal Cord1998; 36: 266. Google Scholar 3 : Hospital readmissions in people with chronic spinal cord injury. Spinal Cord2000; 38: 371. Google Scholar 4 : Long-term urethral catheterisation after spinal injury. Paraplegia1968; 6: 11. Google Scholar 5 : Comparative urological outcome in women with spinal cord injury. J Urol1986; 135: 730. Link, Google Scholar 6 : Urinary tract complications in spinal cord injury patients. Ann Chir Gynaecol1984; 73: 325. Google Scholar 7 : Comparison of bladder management complication outcomes in female spinal cord injury patients. J Urol1995; 153: 1458. Link, Google Scholar 8 : Effect of bladder management on urological complications in spinal cord injured patients. J Urol2000; 163: 768. Link, Google Scholar 9 : A comparison of the urological complications associated with long-term management of quadriplegics with and without chronic indwelling urinary catheters. J Urol1992; 147: 1069. Link, Google Scholar 10 : Urological long-term follow-up in women with spinal cord injuries. Arch Phys Med Rehabil1992; 73: 1029. Google Scholar 11 : Neuromuscular dysfunction of the lower urinary tract and its management. In: . Philadelphia: W. B. Saunders Co.2002: 996. chapt. 26. Google Scholar From the Department of Urology, Churchill Hospital (JO, JR), University Department of Statistics, Oxford (DL) and The National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, England© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 170Issue 5November 2003Page: 1734-1737 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsbladder calculicatheterizationspinal injuriesMetricsAuthor Information J. ORD More articles by this author D. LUNN More articles by this author J. REYNARD More articles by this author Expand All Advertisement PDF downloadLoading ...