Article

For patients with incomplete cervical cord injuries, appropriate urinary
management based on an assessment of voiding and storage function of the bladder
is necessary for a better prognosis, especially during the recovery phase. In our
review of medical records of such patients, we identified factors related to
recovery of bladder function and parameters for predicting prognosis. METHODS: In
this study, we included 234 patients with incomplete cervical cord injuries
admitted to Kanagawa Rehabilitation Hospital. Their medical records were
retrospectively reviewed for various parameters related to final urinary
management measures at discharge. Parameters included age, severity of paralysis,
bladder function over time, urinary sensation and cystometry results. RESULTS:
Patients were managed using urethral catheterization, suprapubic cystostomy,
clean intermittent catheterization (CIC) by oneself or care givers, CIC with
occasional spontaneous voiding, or spontaneous voiding alone. Bladder function
improved in majority of the patients during hospitalization. The severity of
paralysis and urinary sensation are predictive parameters for improvement in
voiding function. In patients who were admitted with catheterization but were
discharged with spontaneous voiding, the period for recovery was 85.2 days on
average (range 16-142 days). CONCLUSIONS: Selection of urinary management
measures for patients with incomplete cervical cord injuries can be performed
adequately by considering the severity of paralysis and urinary sensation.

Langue : ANGLAIS