PDF(Pubmed)
Abstract：
BACKGROUND: Patients with spinal cord injuries/disorders (SCI/D) often suffer from bladder dysfunction, commonly referred to as neurogenic bladder or neurogenic lower urinary tract dysfunction (NLUTD). Standard urologic evaluation and management help to minimize complications such as vesicoureteral reflux, urinary tract infection, and nephrolithiasis. However, we have further encountered patients with more complex issues, such as chronic kidney disease (CKD), end-stage renal disease (ESRD), bilateral nephrectomies, and urinary diversion/augmentation surgeries. Of particular interest, there is a lack of standardized guidance for bladder management in SCI/D patients with ESRD. These patients are at high risk for urological complications and would benefit from codified bladder management strategies.
METHODS: In this article, we present eleven unique cases of NLUTD with associated ESRD and discuss recommendations utilizing simple and commonly available clinical interventions.
CONCLUSIONS: The inherently small population size of SCI/D patients with NLUTD and ESRD makes detailing a large sample size case series difficult. Future studies must aim to include a larger sample size as able, however, to better determine standardized protocols for chronic bladder management in SCI/D patients with NLUTD and ESRD. Experiences from this small case series are offered for consideration.
METHODS: In this article, we present eleven unique cases of NLUTD with associated ESRD and discuss recommendations utilizing simple and commonly available clinical interventions.
CONCLUSIONS: The inherently small population size of SCI/D patients with NLUTD and ESRD makes detailing a large sample size case series difficult. Future studies must aim to include a larger sample size as able, however, to better determine standardized protocols for chronic bladder management in SCI/D patients with NLUTD and ESRD. Experiences from this small case series are offered for consideration.
摘要：
背景：患有脊髓损伤/疾病（SCI/D）的患者经常患有膀胱功能障碍，通常称为神经源性膀胱或神经源性下尿路功能障碍（NLUTD）。标准的泌尿系统评估和管理有助于减少并发症，如膀胱输尿管反流，尿路感染,和肾结石。然而,我们进一步遇到了更复杂问题的患者，如慢性肾脏病（CKD），终末期肾病（ESRD），双侧肾切除术,和尿流改道/增大手术。特别感兴趣的是，SCI/D伴ESRD患者的膀胱管理缺乏标准化指导.这些患者泌尿系统并发症的风险很高，并且将从编码的膀胱管理策略中受益。
方法：在本文中，我们介绍了11例NUUTD与ESRD相关的独特病例,并讨论了使用简单且常用的临床干预措施的建议.
结论：患有NSUTD和ESRD的SCI/D患者的固有群体规模小，因此难以详述大样本量病例系列。未来的研究必须旨在包括更大的样本量，然而,更好地确定SCI/D伴NNUTD和ESRD患者慢性膀胱管理的标准化方案。从这个小案例系列的经验提供考虑。
方法：在本文中，我们介绍了11例NUUTD与ESRD相关的独特病例,并讨论了使用简单且常用的临床干预措施的建议.
结论：患有NSUTD和ESRD的SCI/D患者的固有群体规模小，因此难以详述大样本量病例系列。未来的研究必须旨在包括更大的样本量，然而,更好地确定SCI/D伴NNUTD和ESRD患者慢性膀胱管理的标准化方案。从这个小案例系列的经验提供考虑。
