Urological management in people with traumatic and non-traumatic spinal cord injury in Brazil

Despite the critical need for data to support public health policies in Brazil, there is a glaring lack of national epidemiological studies on neurogenic lower urinary tract dysfunction (NLUTD). This study aimed to illuminate the factors associated with the urological management of NLUTD among individuals with traumatic spinal cord injury (TSCI) and non-traumatic spinal cord injury (NTSCI). Employing a quantitative, cross-sectional, and descriptive design, this study analyzed electronic medical records of NLUTD and SCI patients monitored within the SARAH network from 2007 to 2017. Sociodemographic and clinical data were collected, including the ASIA Impairment Scale, and statistical analyses such as the Mann-Whitney and Pearson's Chi-square tests were conducted. The findings revealed that out of 903 patients, 67% had TSCI and 33% had NTSCI. Clean intermittent catheterization (CIC) was the primary bladder emptying method, utilized by 66.11% of the participants. The average emptying frequency was 4.71 times a day, and urinary incontinence was reported in 58.4% of cases. A significantly higher rate of positive urinary colonization was found among TSCI patients. The study highlighted significant differences in NLUTD management between TSCI and NTSCI patients, with NTSCI patients more frequently achieving voluntary urination and using maneuvers to stimulate urination. These distinctions underscore the need for more individualized approaches and deeper understanding of each type of spinal cord injury, aiming to enhance bladder rehabilitation programs in Brazil.