Factors associated with ultrasound diagnosed neurogenic bladder complications following spinal cord injury

ABSTRACT

@#secondary medical impairment following spinal cord injury(SCI). Ultrasound (US) of the kidneys, ureters and bladder(KUB) has been recommended as a useful, non-invasivesurveillance method with good diagnostic sensitivity. Thisstudy aims to understand US diagnosed NB complicationsand identify its associated factors.Methods: We enrolled all patients referred for SCIrehabilitation from 2012 to 2015 that fulfilled our studycriteria. Data that were retrospectively reviewed includeddemographic and clinical characteristic data; and US KUBsurveillance studies.Results: Out of 136 electronic medical records reviewed, 110fulfilled the study criteria. The prevalence of NB in our studypopulation was 80.9%. We found 22(20%) of the patientsshowed evidence of US diagnosed NB complications withthe mean detection of 9.61±7.91 months following initial SCI.The reported NB complications were specific morphologicalchanges in the bladder wall 8(36.4%); followed byunilateral/bilateral hydronephrosis 7(31.8%); bladder and/orrenal calculi 5(22.7%); and mixed complication 2(9.1%)respectively. Half of the patients with NB complications hadurodynamic diagnosis of neurogenic detrusor overactivitywith/without evidence of detrusor sphincter dyssynergia.We found co-existing neurogenic bowel, presence ofspasticity and mode of bladder management weresignificantly associated factors with US diagnosed NBcomplications (p<0.05), while spasticity was its predictorwith adjusted Odds Ratio value of 3.93 (1.14, 13.56).Conclusion: NB is a common secondary medical impairmentin our SCI population. A proportion of them had USdiagnosed NB complications. Co-existing neurogenic bowel,presence of spasticity and mode of bladder managementwere its associated factors; while spasticity was itspredictor.