Temporal development of unfavourable urodynamic parameters during the first year after spinal cord injury.

Autor:	Anderson CE; Swiss Paraplegic Research, Nottwil, Switzerland.; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Kozomara M; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Department of Urology, University Hospital Zürich, University of Zürich, Zürich, Switzerland., Birkhäuser V; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Bywater M; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland., Gross O; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Kiss S; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Department of Urology, Cantonal Hospital Aarau, Aarau, Switzerland., Knüpfer SC; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Department of Urology, Clinic for Urology, University Hospital Bonn, Bonn, Germany., Koschorke M; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Leitner L; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Mehnert U; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Sadri H; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Sammer U; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Stächele L; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Tornic J; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Department of Urology, Winterthur Cantonal Hospital, Winterthur, Switzerland., Liechti MD; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Brinkhof MWG; Swiss Paraplegic Research, Nottwil, Switzerland.; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland., Kessler TM; Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Jazyk:	angličtina
Zdroj:	BJU international [BJU Int] 2023 Apr; Vol. 131 (4), pp. 503-512. Date of Electronic Publication: 2022 Oct 28.
DOI:	10.1111/bju.15918
Abstrakt:	Objectives: To describe the temporal development of and risk factors for the occurrence of unfavourable urodynamic parameters during the first year after spinal cord injury (SCI). Patients and Methods: This population-based longitudinal study used data from 97 adult patients with a single-event traumatic or ischaemic SCI who underwent video-urodynamic investigation (UDI) at a university SCI centre. The first occurrences of unfavourable urodynamic parameters (detrusor overactivity combined with detrusor sphincter dyssynergia [DO-DSD], maximum storage detrusor pressure ≥40 cmH 2 O, bladder compliance <20 mL/cmH 2 O, vesico-ureteric reflux [VUR] and any unfavourable parameter [composite outcome]) were evaluated using time-to-event analysis. Results: The majority of the population (87/97 [90%]) had at least one unfavourable urodynamic parameter. Most unfavourable urodynamic parameters were initially identified during the 1- or 3-month UDI, including 92% of the DO-DSD (78/85), 82% of the maximum storage pressure ≥40 cmH 2 O (31/38), and 100% of the VUR (seven of seven) observations. No low bladder compliance was observed. The risk of DO-DSD was elevated in patients with thoracic SCI compared to those with lumbar SCI (adjusted hazard ratio [aHR] 2.38, 95% confidence interval [CI] 1.16-4.89). Risk of maximum storage detrusor pressure ≥40 cmH 2 O was higher in males than females (aHR 8.33, 95% CI 2.51-27.66), in patients with a cervical SCI compared to those with lumbar SCI (aHR 14.89, 95% CI 3.28-67.55), and in patients with AIS Grade B or C compared to AIS Grade D SCI (aHR 6.17, 95% CI 1.78-21.39). No risk factors were identified for the composite outcome of any unfavourable urodynamic parameter. Conclusions: The first UDI should take place within 3 months after SCI as to facilitate early diagnosis of unfavourable urodynamic parameters and timely treatment. Neuro-urological guidelines and individualised management strategies for patients with SCI may be strengthened by considering sex and SCI characteristics in the scheduling of UDIs. (© 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)
Databáze:	MEDLINE
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