engleski

The impact of spinal cord injury on renal pathology

54 male patients (29.9 ą 7 y.) with spinal cord injury have been investigated according to their urological impairments. They were victims of war and 2/3 of them had explosive and gunshot wounds and 1/3 blunt trauma. 45 had para and 9 tetraplegia. Time between injury and our investigation was between 2 and 47 months. Majority of them wore permanent catheter inserted elsewhere 4 months (0 - 31). We could not find significant linear correlation between the level of injury and rehabilitation (Barthel index). 46 patients had more episodes of significant bacteriuria, 9 had bladder or kidney stones, 3 had hydronephrosis, ureteral reflux 7, and in 13 patients were visible renal parenchymal fibrosis in ultrasound. The higher lesions had had higher incidence of renal fibrosis (P = 0.0021, Fisher, s exact test). The incidence of stones, hydronephrosis and bacteriuria showed no significant association or correlation (Mann-Whitney test) with duration of plegia, permanent catheter wearing, age and level of injury (P 0.10). Assumption that anatomically higher lesions had higher incidence of vesicoureteral reflux was not quite significant (P = 0.064).Urodynamic presented only 12 % with retained sensibility, and only 18.5% of patients had balanced bladder (less than 60 ml of residual urine and no incontinence). Dominant bladder lesion was hyperactive detrusor (51%), atonic detrusor appeared in 17 %, and detrusor-sphincter dyssinergia in 24 %.

paraplegia; renal impairment

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