NONOPERATIVE MANAGEMENT OF THE URINARY-TRACT IN SPINAL-CORD INJURY

被引：13

作者：

DMOCHOWSKI, RR ^{[1
]}

GANABATHI, K ^{[1
]}

LEACH, GE ^{[1
]}

机构：

[1] KAISER PERMANENTE MED CTR,DEPT UROL,4900 SUNSET BLVD,LOS ANGELES,CA 90027

来源：

NEUROUROLOGY AND URODYNAMICS | 1995年 / 14卷 / 01期

关键词：

SPINAL CORD INJURY; MANAGEMENT; INTERMITTENT CATHETERIZATION; COMPLICATIONS;

D O I：

10.1002/nau.1930140109

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Various options exist for the management of the lower urinary tract in chronic spinal cord injury. These options include chronic indwelling catheterization, urethral sphincterotomy, and intermittent catherization supplemented with anticholinergic agents. Sixty-four spinal cord injured patients, treated with intermittent catheterization and anticholinergic therapy, were evaluated for long-term efficacy in maintaining upper tract status and preservation or improvement in continence. Complications of therapy were also evaluated. Therapy was based upon initial urodynamic evaluation followed by limited subsequent evaluation of the urinary tract. Mean follow-up was 54 months. Only 1 patient developed hydronephrosis. Fifty-nine patients either became continent or experienced improved continence on therapy. Eight patients required surgical procedures either to increase outlet resistance (2) or to decrease intravesical pressures (6). The most common complication of therapy was urinary tract infection. Thirty-nine infections occurred in 23 patients, 16 of which were febrile. Fifteen patients were non-compliant with treatment recommendations. The only factor related to therapeutic complications which reached statistical significance was non-compliance with therapy. The combined use of intermittent catheterization and anticholinergic agents provides an effective means to prevent hydronephrosis and establish continence in chronic spinal injury. (C) 1995 Wiley-Liss, Inc.

引用

页码：47 / 55

页数：9

共 22 条

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