After Spinal Cord Injury (SCI), patients often face major, recurring complications related to their bladders that can impact on their health, wellbeing and quality of life. Researchers are trying to reduce these complications.
Previously, the cause of bladder infections after SCI had not been thoroughly understood, leaving clinicians able only to focus on the treatment, rather than prevention.
Unfortunately, just one infection can easily develop into a vicious cycle of repeated, chronic infections. This can then result in prolonged hospitalisation, reduced resistance to antibiotics, and long-term damage to bladder and kidney health. The patient's general wellbeing, mental health, social life, and return to work process is affected.
Led by Associate Professor James A Brock from the University of Melbourne's Department of Anatomy and Neuroscience, this project tests a new theory: that SCI weakens the ability of the bladder lining (urothelium) to resist infection because it damages a nerve that supplies the bladder. If the theory is confirmed, it will pave the way for the development of preventative interventions in this area, which will hopefully make a real difference to the lives of people living with spinal cord injury.
CAUSES (Complications Audit of Urological Issues in Spinal Cord Injury Evaluation Study) used two years of data from the Victorian Spinal Cord Service (VSCS) to closely observes secondary bladder complications straight after SCI and their management. The project's focus was on determining whether the common practice of using an indwelling catheter actually led to further complications down the track. An indwelling catheter is inserted and remains in place to ensure the bladder is emptied.
The report confirms that there is a very high rate of urinary tract infection incidence among people recently injured in the SCI population at Austin Health. The most likely cause of this is the use of indwelling catheter, as these catheters provide optimal conditions for bacteria to grow and flourish.This finding adds to the pool of evidence supporting the earlier removal of indwelling catheter and will help to inform best practice in this area.
Significantly, this report also reveals that coded hospital data is not the most accurate measure of bladder complications for people living with SCI. The researchers found that VSCS data contained many coding errors, and an audit of hospital files proved to be much more reliable. This finding will help to guide improved data collection and outcome measuring at the VSCS in the future.