REVIEW OF URINARY-TRACT ABNORMALITIES IN 100 PATIENTS WITH SPINAL-CORD PARALYSIS

The importance of long term follow up of neurological status of patients with spinal cord injuries is well recognised. Although there is a general agreement about continued radiological surveillance of these patients, there is lack of uniformity of approach and guidelines as to how frequently such screening should be undertaken and for how long it should be continued. The present study, following analysis of clinical and radiological data of 100 sequential patients, indicates that morphological complications of urinary tract are common (63% in patients studied) and that a significant number (70-75%) develop complications within the first year following onset of spinal cord dysfunction. The development of these changes appears to be related to more than 8 weeks of presence of continous indwelling catheter during patients' initial bladder management. The study further suggests that the risk of developing demonstratable abnormalities after 10 years of normal radiology is very small (approximately 1%). It is, therefore, suggested that patients with spinal cord paralysis should have surveillance of urinary tract annually for 10 years and that the follow up beyond 10 years should be determined by clinical necessity rather than a fixed protocol.