Management of neurogenic bladder in patients with spinal cord injuries/disorders and end stage renal disease: a case series.

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.

Neuropathic spinal arthropathy leading to spine disruption, spinal cord transection, and aortic displacement: brief case report.

INTRODUCTION: Charcot spinal arthropathy (CSA) is an infrequent but potentially devastating complication after spinal cord injury. CASE PRESENTATION: We report a case of a man with longstanding T3 complete (AIS A) paraplegia who developed severe CSA with spine disruption and aortic displacement. DISCUSSION: Acute management of this patient is described along with both conservative and surgical management considerations and challenges as described in other reports.