Email updates

Keep up to date with the latest news and content from Patient Safety in Surgery and BioMed Central.

Open Access Case report

Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication

Subramanian Vaidyanathan1*, Fahed Selmi1, Kottarathil Abraham Abraham2, Peter Hughes3, Gurpreet Singh4 and Bakul Soni1

Author Affiliations

1 Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN, United Kingdom

2 Department of Renal Medicine, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN, United Kingdom

3 Department of Radiology, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN, United Kingdom

4 Department of Urology, Southport and Formby District General Hospital, Town Lane, Southport, PR8 6PN, United Kingdom

For all author emails, please log on.

Patient Safety in Surgery 2012, 6:22  doi:10.1186/1754-9493-6-22

Published: 26 September 2012

Abstract

Background

Condom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications.

Case report

A 32-year old, male person, sustained complete paraplegia at T-11 level in 1985. He had been using condom catheter. Eleven years after sustaining spinal injury, intravenous urography showed no radio-opaque calculus, normal appearances of kidneys, ureters and bladder. Blood urea and Creatinine were within reference range. A year later, urodynamics revealed detrusor pressure of 100 cm water when detrusor contraction was initiated by suprapubic tapping. This patient was advised intermittent catheterisation and take anti-cholinergic drug orally; but, he wished to continue penile sheath drainage. Nine years later, this patient developed bilateral hydronephrosis and renal failure. Indwelling urethral catheter drainage was established. Five months later, ultrasound examination of urinary tract revealed normal kidneys with no evidence of hydronephrosis.

Conclusion

Spinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure. Intermittent catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder.