Introduction

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.

Case presentation

In this article, we present eleven unique cases of NLUTD with associated ESRD and discuss recommendations utilizing simple and commonly available clinical interventions.

Discussion

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.

中文翻译：

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脊髓损伤/疾病和终末期肾病患者神经源性膀胱的治疗：病例系列

介绍

脊髓损伤/疾病 (SCI/D) 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)。标准泌尿系统评估和管理有助于最大限度地减少膀胱输尿管反流、尿路感染和肾结石等并发症。然而，我们还遇到了患有更复杂问题的患者，例如慢性肾脏病（CKD）、终末期肾病（ESRD）、双侧肾切除术和尿流改道/强化手术。特别令人感兴趣的是，对于患有 ESRD 的 SCI/D 患者的膀胱管理缺乏标准化指导。这些患者出现泌尿系统并发症的风险很高，将受益于规范的膀胱管理策略。

案例展示

在本文中，我们介绍了 11 例 NLUTD 与 ESRD 相关的独特病例，并讨论了利用简单且常用的临床干预措施的建议。

讨论

患有 NLUTD 和 ESRD 的 SCI/D 患者群体规模本来就较小，这使得详细描述大样本病例系列变得困难。然而，未来的研究必须旨在纳入更大的样本量，以便更好地确定患有 NLUTD 和 ESRD 的 SCI/D 患者慢性膀胱管理的标准化方案。这个小案例系列的经验可供考虑。