Current practice patterns in the urologic surveillance and management of patients with spinal cord injury

Abstract

Objectives To determine current trends in management and surveillance of the spinal cord injury (SCI) population among specialized urologists who routinely work and provide care to patients with SCI. There is a lack of consensus on the optimal urologic surveillance and management protocol of the urinary tract in SCI patients. Methods A mailed questionnaire was sent to the 269 American members of the Society for Urodynamics and Female Urology (SUFU). The type of investigation used in the assessment and follow-up of upper and lower urinary tract function in SCI patients and their optimal frequency and management modalities were the topics of inquiry. Results One hundred sixty of the 269 urologists responded for a response rate of 60%. Most physicians (85%) favor a yearly renal ultrasound for routine surveillance of the upper tracts, whereas more than half (65%) routinely use videourodynamic studies for evaluation of the lower urinary tract. The combination of clean intermittent catheterization (CIC) plus anticholinergic agents is the favored modality for management of hyperreflexic bladder, whereas CIC alone is preferred for the areflexic bladder. Conclusions This study confirms that most urologists working with SCI patients follow principles reported in published data regarding the need for evaluation, surveillance, and management of the urinary tract. However, there is a lack of consensus in the specific methods used for surveillance of the urinary system. The present results emphasize the need for clear guidelines in this area.