Medical Advances Result in Dramatic Drops of UTI/Kidney Failure Related Deaths for SCI Patients

Urinary tract infections (UTIs) used to be the leading cause of death for those with SCI.  In the 1940s, UTI related death came as swiftly – within months of the injury.  Once antibiotics were invented, people started living longer but kidney failure became the leading cause of death.  Now, with advances in modern medicine, less than three percent of those with SCI die from kidney failure.

Under normal conditions, the bladder is either filling or emptying.  When it is relaxed it fills and the sphincter stays closed so there is no leakage.  When it is time to empty, the bladder contracts and the sphincter relaxes so the urine can flow out.  The bladder and sphincter muscles are coordinated to contract and relax at the correct time.  These reflexes are “wired” into the brainstem and spinal cord.  After SCI, these reflex patterns no longer work and two basic problems can occur:

1.       Filling problems (incontinence or leaking) when the bladder is overactive and contracts too much or at the wrong time, of the sphincter doesn’t contract enough to keep the urine from leaking out.

2.       Emptying problems (retention) when the bladder doesn’t contract enough or the sphincter won’t relax.

The goals of medical management are to establish a method of bladder drainage that is the simplest, most convenient and expensive method to keep the patient dry, avoid serious complications and treatment side effects, and to preserve the kidneys for life.   The methods are different depending upon factors like: the amount of nerve preservation, the amount of hand function, gender, the amount of mobility required, likelihood of compliance, remote location, amount of daily time  time available.

This information is from a presentation at the SCI Forum by Stephen Burns, MD, SCI Service, VA Puget Sound Health Care System and associate professor, Department of Rehabilitation Medicine, University of Washington October 13, 2009. For the full report and video.

Leave a Reply

Your email address will not be published. Required fields are marked *

About Karen
Karen Koehler, partner at the nationally recognized law firm of SKW, blogs about all things related to spinal cord injuries...More
SKW on Facebook
Follow Us
   
Subscribe

Add this blog to your feeds or
subscribe by email using the form below.

Join 3 other subscribers

Favorite Quotation
On Another's Sorrow
Can I see another's woe,
And not be in sorrow too?
Can I see another's grief,
And not seek for kind relief.

Can I see a falling tear.
And not feel my sorrows share,
Can a father see his child,
Weep, nor be with sorrow fill'd.

Can a mother sit and hear.
An infant groan an infant fear?
No no never can it be,
Never never can it be

And can he who smiles on all
Hear the wren with sorrows small
Hear the small bird's grief & care
Hear the woes that infants bear

And not sit beside the nest
Pouring pity in their breast.
And not sit the cradle near
Weeping tear on infant's tear.

And not sit both night & day.
Wiping all our tears away.
O! no never can it be.
Never, never can it be!

He doth give His joy to all:
He becomes an infant small,
He becomes a man of woe,
He doth feel the sorrow too.

Think not thou canst sigh a sigh,
And thy Maker is not by:
Think not thou canst weep a tear,
And thy Maker is not near.

O He gives to us His joy,
That our grief He may destroy:
Till our grief is fled and gone
He doth sit by us and moan.


— William Blake