Abstract
Objectives:
To present a system of urological care for patients with cervical spinal cord injury (SCI) in the Spinal Cord Unit in Prague.
Methods:
Forty-one out of 412 patients hospitalized with acute SCI between 2007 and 2012 with motor complete SCI (AIS A,B) at the C4–C7 motor level and with sufficient follow-up duration were selected. Patients were trained using a male bladder catheterization model (37 with a transurethral catheter and 4 with a suprapubic catheter) to perform intermittent catheterization (IC) using an ergohand device, and were later encouraged to perform self-catheterization.
Results:
On the basis of the motor level of the SCI, 8 out of the 41 study patients were assigned to group 1 (C4), 11 to group 2 (C5), 15 to group 3 (C6) and 7 to group 4 (C7). All patients in group 1 had an indwelling urinary catheter. In group 2, 6 patients (54.6%) learned to perform IC, with 2 of them needing another person’s assistance. In 5 patients (45.5%), suprapubic cystostomy was maintained (insufficient functional grip, severe autonomic dysreflexia, prompt reflex erection). Group 3 included 12 patients (80%) performing intermittent catheterization and 3 patients (20%) with suprapubic cystostomy (insufficient functional grip, post-bladder-surgery condition, cognitive impairment). In group 4, only 1 patient (14.3%) had an indwelling catheter due to severe abductor spasticity, whereas the remaining 6 (85.7%) learned to perform IC.
Conclusions:
These findings suggest that patients with cervical SCI below the C5 motor level are able to learn self-catheterization, which increases independence and decreases the risk of urinary infection and stone formation.
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References
Lapides J, Diokno AC, Silber SJ, Lowe BS . Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol 1972; 107: 458–461.
Samson G, Cardenas DD . Neurogenic bladder in spinal cord injury. Phys Med Rehabil Clin N Am 2007; 18: 255–274.
Krassioukov A, Warburton DE, Teasell R, Eng JJ., Spinal Cord Injury Rehabilitation Evidence Research Team. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Arch Phys Med Rehabil 2009; 90: 682–695.
Wyndaele JJ, Madersbacher H, Kovindha A . Conservative treatment of the neuropathic bladder in spinal cord injured patients. Spinal Cord 2001; 39: 294–300.
Kirshblum SC, Waring W, Biering-Sorensen F, Burns SP, Johansen M, Schmidt-Read M et al. Reference for the 2011 revision of the International Standards for Neurological Classification of Spinal Cord Injury. J Spinal Cord Med 2011; 34: 547–554.
Doll U, Maurer-Burkhard B, Spahn B, Fromm B . Functional hand development in tetraplegia. Spinal Cord 1998; 36: 818–821.
Di Benedetto P . Clean intermittent self-catheterization in neuro-urology. Eur J Phys Rehabil Med 2011; 47: 651–659.
Asayama K, Kihara K, Shidoh T, Shigaki M, Ikeda T . The functional limitations of tetraplegic hands for intermittent clean self-catheterisation. Paraplegia 1995; 33: 30–33.
Bernuz B, Guinet A, Rech C, Hugeron C, Even-Schneider A, Denys P et al. Self-catheterization acquisition after hand reanimation protocols in c5-c7 tetraplegic patients. Spinal Cord 2011; 49: 313–317.
Acknowledgements
The study was supported by ‘Movement without Help’ foundation.
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Kriz, J., Relichova, Z. Intermittent self-catheterization in tetraplegic patients: a 6-year experience gained in the spinal cord unit in Prague. Spinal Cord 52, 163–166 (2014). https://doi.org/10.1038/sc.2013.154
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DOI: https://doi.org/10.1038/sc.2013.154
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