Keywords
Urological dysfunction
Surgical intervention
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Abstract
Objective: Review the main surgical urological procedures and their indications in patients with spinal cord injury. Literature review: Spinal cord injuries course with progressive neurogenic dysfunction of the lower urinary tract. There is an association between the level of injury and bladder dysfunction. Suprasacral injuries course with neurogenic detrusor hyperactivity with risk of external sphincter dyssynergia. Sacral injuries result in detrusor areflexia. Treatment aims the safe storage of urine, efficient bladder emptying, adequate urinary continence, and minimal complications. Conservative treatment includes drugs, intermittent catheterization or indwelling bladder catheter, assisted emptying and external devices. Surgical procedures such as injection of botulinum toxin type A into the detrusor and bladder enlargement aim to decrease detrusor contractility. The use of suburethral bands and the artificial urinary sphincter increase the resistance of the bladder neck. Finally, sacral neuromodulation is indicated to improve detrusor contractility. Conclusion: In view of the therapeutic options, the choice of treatment must consider the patient's wish. Constant medical monitoring aims to prevent complications and improve the quality of life of these patients.
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