Long-Term Urologic Evaluation Following Spinal Cord Injury

Spinal cord injury (SCI) has significant long-term urologic consequences that impact quality of life (QOL) and can influence life expectancy. Neurogenic bladder, urinary tract infections, and autonomic dysreflexia are common consequences of SCI. It is essential to conduct a focused patient interview to address these consequences. History should include a basic assessment of the patient and symptomatology as per a validated instrument, as well as a detailed urologic diary. The physical examination should include evaluation of the extent of the neurologic injury as per the American Spinal Association Injury (ASIA) scale, the affected system as well as examination maneuvers done in those without neurologic injury. Investigations should include urodynamic testing and cystoscopy. In managing patients with SCI, pharmaceutical agents and intermittent catheterization are utilized normally in an effort to protect the upper urinary tract, achieve and maintain urinary continence, and optimize lower urinary tract function and quality of life (QOL).