Turkish Journal of Physical Medicine and Rehabilitation 2012 , Vol 58 , Num 1

Urinary Dysfunctions Associated With Spinal Cord Injury

Serdar Koçer 1 ,Belgin Erhan 2
1 Centre de Readaptation de Coubert, Fransa
2 İstanbul Fiziksel Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye
DOI : 10.4274/tftr.46658

After the Second World War, urinary dysfunctions due to spinal cord injury had gained more importance and the life expectancy and quality of life of the patients had increased due to the improvements in this field. The management and follow-up period of urinary dysfunctions can be examined in three stages: initial stage after the injury, rehabilitation stage and long-term follow-up stage. Urodynamic and videourodynamic evaluations are the gold standards in the diagnosis. Bladder filling pressure, bladder compliance and bladder sphincter dyssynergia are the important prognostic factors during the management of neurogenic bladder. The aim of the treatment is to protect upper urinary tract, to lower the complications in the lower urinary tract and to improve the quality of life of the patient. Recently, botulinum toxin injections and improved surgical techniques become good treatment options besides clean intermittent catheterization and oral medical agents. The success of the treatment is based on long-term follow-up of the patients with appropriate treatment strategy. In this review, the current developments in the diagnosis and management of urinary dysfunctions seen after spinal cord injury will be discussed. 

Keywords : Spinal cord injury; neurogenic bladder; urodynamic; botulinum toxin; management; surgical management