Neuro-urological monitoring of spinal cord injury patients in a physical medicine and rehabilitation department.

Abstract

Patients with spinal cord injuries are at high risk of neuro-urological complications, particularly urinary tract infections and impaired renal function. Specific recommendations, notably those issued by GENULF, aim to provide a framework for monitoring these patients. However, their application in clinical practice remains uncertain. The aim of this study is to assess the rate of follow-up in line with GENULF recommendations in a cohort of spinal cord injured patients at the University Hospital of Limoges, and to determine the prevalence and risk factors associated with neuro-urological complications. This retrospective observational monocentric study included 92 spinal cord injured patients undergoing urodynamic follow-up in a physical medicine and rehabilitation department. Follow-up was deemed compliant if biological, morphological and urodynamic assessments were performed at the recommended frequency. Complications analyzed included impaired renal function, urinary tract infections and symptomatic lithiasis. Only 51% of patients benefited from complete follow-up in line with recommendations. Forty-one percent had at least one complication, mainly urinary tract infections (28.3%). Appropriate urodynamic and biological monitoring was associated with a significant reduction in the risk of infection. Older age and the use of indwelling catheters were associated with impaired renal function. This study highlights both the frequency of neuro-urological complications and the limitations of implementing the GENULF recommendations. Efforts must be made to strengthen medical coordination and raise patient awareness of follow-up, notably through therapeutic education and telemedicine tools. LEVEL OF EVIDENCE: 4, grade of recommendation: C - retrospective study.