Relationship between Galloway's Hostility Score and Upper Urinary Tract Abnormalities in Neuropathic Bladder Caused by Spinal Cord Injury

Park, Kyung Min; Rho, Joon; Kim, Chul Sung

Abstract

PURPOSE: The primary objective in the management of neuropathic bladder caused by spinal cord injury is the preservation of renal functions because renal failure is the cause of death in neuropathic bladder patients. We evaluated risk factors for upper urinary tract abnormalities in neuropathic bladder caused by spinal cord injury.
MATERIALS AND METHODS
From July 1997 to February 2001, total of 48 patients of neuropathic bladder caused by spinal cord injury were evaluated by urodynamic study, excretory urography, voiding cystourethrography, and DMSA renal scan. The risk factors associated with upper urinary tract abnormalities were analyzed.
RESULTS
Urodynamic evaluation revealed that 7 (15%) of 48 cases had detrusor hyperreflexia without detrusor external sphincter dyssynergia (DESD), 20 (42%) had detrusor hyperreflexia with DESD, and 18 (38%) had detrusor areflexia. 20 (42%) of 48 cases had low compliance. Upper urinary tract abnormalities were present in 15 (75%) of 20 cases that had DESD and in 12 (60%) of 20 cases that had low compliance. In addition, 19 (86%) of 22 cases with a hostility score of more than 6 went on to develop upper urinary tract changes.
CONCLUSIONS
In the management of neuropathic bladder caused by spinal cord injury, the abnormal urodynamic parameters (DESD and low compliance) and hostility score of more than 6 should be factored into the assessment of upper urinary tract deterioration.