Spinal cord injury in children

Long-term urodynamic and urological outcomes

Suzanne E. Generao, Joseph P. Dall'Era, Anthony R Stone, Eric A Kurzrock

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Urological complications in adults with spinal cord injuries (SCIs) are well documented. We sought to determine the effect of SCI on the developing bladder and kidneys in the child. Materials and Methods: We retrospectively reviewed cases of SCI with 1-year minimum followup. We identified 42 children with an average age at injury of 5.3 years (range 1 day to 14 years). Mean followup was 5.5 years (range 1 to 15.5). Videourodynamics, sonograms, infection, medications and continence were reviewed. Safe bladder capacity was defined as the pressure specific volume at 40 cm water or less. Patients were divided into 3 groups based on level of injury-cervical (10), thoracic (26) and lumbar (6). Results: Bladder management included clean intermittent catheterization in 40 of 42 patients and antispasmodics in 37. No patient had reflux, hydronephrosis or renal scarring. In the cervical group safe bladder capacity was less than the expected capacity in 80% of patients but all patients undergoing multiple urodynamics had increasing capacity with time. In the thoracic group 58% of patients had a safe bladder capacity less than expected and 76% of those undergoing multiple urodynamics had increasing capacity. In the lumbar group 50% of patients had a safe bladder capacity less than expected and 67% of those undergoing multiple urodynamics had increasing capacity. Conclusions: To our knowledge this is the largest and longest urological study of young children with SCI. Early clean intermittent catheterization and use of anticholinergics appear to prevent upper tract deterioration, improve continence and decrease infections. Serial urodynamics confirm increasing safe capacity with growth in most children. Close followup is necessary as bladder characteristics may change with time.

Original languageEnglish (US)
Pages (from-to)1092-1094
Number of pages3
JournalJournal of Urology
Volume172
Issue number3
DOIs
StatePublished - Sep 2004

Fingerprint

Urodynamics
Spinal Cord Injuries
Urinary Bladder
Intermittent Urethral Catheterization
Thorax
Kidney
Parasympatholytics
Hydronephrosis
Wounds and Injuries
Cholinergic Antagonists
Infection
Cicatrix
Pressure
Water
Growth

Keywords

  • Bladder, neurogenic
  • Pediatrics
  • Spinal cord injuries
  • Treatment outcome
  • Urodynamics

ASJC Scopus subject areas

  • Urology

Cite this

Spinal cord injury in children : Long-term urodynamic and urological outcomes. / Generao, Suzanne E.; Dall'Era, Joseph P.; Stone, Anthony R; Kurzrock, Eric A.

In: Journal of Urology, Vol. 172, No. 3, 09.2004, p. 1092-1094.

Research output: Contribution to journalArticle

Generao, Suzanne E. ; Dall'Era, Joseph P. ; Stone, Anthony R ; Kurzrock, Eric A. / Spinal cord injury in children : Long-term urodynamic and urological outcomes. In: Journal of Urology. 2004 ; Vol. 172, No. 3. pp. 1092-1094.
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