Urination disorders in patients with spinal cord injury

Abstract

Objective. To study the structure of neurogenic urination disorders in patients with spinal cord injuries at various levels.
Materials and methods. 60 patients with spinal cord injuries and neuromuscular bladder dysfunction were examined. The diagnosis was made on the basis of the presented diagnostic algorithm. Urine diversion by patients was carried out in four main ways: 1) uncontrolled urination or assisted emptying of the bladder («tapping», «squeezing») and / or using a urocondom, diaper -- in 20 patients (33,4 %); 2) assisted emptying of the bladder and self-catheterization - in 20 patients (33,4 %); 3) periodic self- catheterization -- in 18 patients (29,9 %); 4) an indwelling urethral catheter/cystostomy was present in 2 (3,3 %) patients.
Results. Thus, an analysis of 60 patients with neuromuscular dysfunction of the bladder after traumatic spinal cord injury showed that it is reasonable to distinguish 2 main types of urination disorders: 1) patients with preserved spontaneous urination, as well as patients with partially preserved independent urination and self-catheterization (1 group,33,3 %). 2) patients who do not have an independent act of urination, urine diversion is carried out only by self-catheterization, a permanent urethral catheter or using a cystostomy (2 group). Patients of the first group are patients with detrusor hyperrefflexia (with a hyperreflex bladder), patients of the second group - with detrusor hyporeflexia (with a hyporeflex bladder).
Conclusion. The proposed division into groups is justified in terms of differences in urinary diversion, as well as existing differences in the causes and levels of spinal cord injury, bladder capacity, and upper urinary tract complications.