Management of urinary disorders in myelitis and spinal cord compression

Abstract

Urinary disorders are frequent in spinal cord injury and complications make prognosis restricted and alter the quality of life. Early and adaptative managment improve quality of life. But in developping contry, so many diffcults make this managment late, and ofen limited. The aim of our study was to evaluate our management in urinary disorders associated of spinal cord injury. Patients and methods: A prospective study was done at the departments of Physical medicine and Neurology in the teaching hospital, Fann, Dakar Senegal. Were included, all patients with urinary disorders concomittent of a spinal cord injury. Patients with others diseases which can explain the urinary symptoms ,were excluded. After determine the Urinay symptoms (Urinary symptoms profile scale) and quality of life (qualiveen short form), patients meet the specialist of rehabilitation who establish type of management of urinary disorders. Secondly patients were received in a variable time, for apreciation evolution. Results: 39 patients were included. Mean of age was 42,7 years and sex ratio (H/F) 1.6. Dysuria associated of overactive badders (38,46%) and overactive bladers (28,20%) dominate the symptoms. Urinary infections (15.4%) were the common complications. Risk factors of alteration of quality of life were overactive blader and leaks during physical effort. The overage decline was 2.7 years. Quality of life was improved by Alfuzozine in all patients with score dysuria under 0,63 and by Oxybutinine in 64.3%. 5 patients benificed of perineal rehabilitation. Permanent catheterization noted in 17.9% of cases. Discussion and conclusion: Our results are similar of the littérature according for symptoms and risk factor of alteration of quality life. Drugs treatment can improve the quality of life. Intermittent catheterization is difficult in our practice.