2009, Number 6
Rev Mex Urol 2009; 69 (6)
Merayo-Chalico CE, Saavedra-Briones DV, Pérez-Zavala R, Durán-Ortiz S
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ABSTRACTIntroduction: Each year there are 10,000 cases of spinal cord injury (SCI) in the United States. Eighty-two percent of these injuries occur in men and mean age is 26 years, having a great impact on the population in regard to their resulting consequences and complications. Urologic management of these patients is fundamental in avoiding further deterioration of quality of life. Urinary lithiasis is reported in 8% of SCI patients and up to 36% develop bladder lithiasis within the first 8 years after SCI.
Objective: To determine bladder lithiasis prevalence in SCI patients at the Instituto Nacional de Rehabilitación (INR) and to report the surgical clinical experience of minimally invasive extracorporeal lithotripsy treatment.
Materials and methods: The present study is a descriptive study of SCI patients treated in the Urology Service for bladder lithiasis diagnosed by means of simple abdominal radiograph and treated with extracorporeal lithotripsy.
Results: Of the total of 439 SCI patients, 332 (75.6%) were men and 107 (24.4%) were women. Mean age was 25.5 years. Bladder lithiasis incidence was 7.2% (n=32) in the 439 patients. In 314 patients, bladder emptying was managed as follows: clean intermittent catheterization (n=249) or permanent bladder catheter (n=65). Bladder lithiasis presented in 12 patients (4.8%) of the clean catheter group and in 20 patients (26.6%) of the permanent catheter group. There was statistical significance (P= 0.00001) for greater risk of presenting with bladder lithiasis in patients with permanent bladder catheter than in those with clean intermittent catheter. More than 75% of SCI patients developed lithiasis within the first two years after injury.
Conclusions: Bladder lithiasis is more frequent in patients with permanent bladder catheter than in patients with clean intermittent catheter and there is greater bladder lithiasis development within the first two years after SCI.