Pathophysiology and Treatment of Secondary Hydronephrosis after Spinal Cord Injury (review) / 中国康复理论与实践

ABSTRACT

@#Hydronephrosis after spinal cord injury (SCI) may result in renal insufficiency which ranks as the most common late cause of death in SCI patients. SCI may cause vesicourethral dysfunction of nerve regulation, which in turn brings about functional obstruction, high intravesical pressure, increase of the incidence and frequency of detrusor uninhibitory constractions, leading to hydronephrosis. The paramount principle of prevention and treatment of hydronephrosis is keeping low vesical pressure (storage pressure <40 cmH2O, voiding pressure <60 cmH2O). Oral anticholinergics combined with intermittent catheterization are the best choice for the slight hydronephrosis, urinary operations such as botulinum toxin injection into detrusor, transurethral sphincterotomy, ileocystoplasty may be needed for the moderate and severe hydronephrosis.