Practice patterns of Japanese physicians in urologic surveillance and management of spinal cord injury patients

• Published in: Spinal cord Vol. 44; no. 6; pp. 362 - 368
• Main Authors: KITAHARA, S, IWATSUBO, E, NOHARA, Y, YASUDA, K, USHIYAMA, T, NAKAI, H, SUZUKI, T, YAMASHITA, T, SATO, R, KIHARA, T, YAMANISHI, T
• Format: Journal Article
• Language: English
• Published: London Nature Publishing 01.06.2006; Nature Publishing Group
• Subjects: Biological and medical sciences; Cerebrospinal fluid. Meninges. Spinal cord; Comorbidity; Health Care Surveys; Incidence; Injuries of the nervous system and the skull. Diseases due to physical agents; Japan - epidemiology; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Population Surveillance - methods; Practice Patterns, Physicians' - statistics & numerical data; Spinal Cord Injuries - diagnosis; Spinal Cord Injuries - epidemiology; Spinal Cord Injuries - therapy; Surveys and Questionnaires; Traumas. Diseases due to physical agents; Urologic Diseases - diagnosis; Urologic Diseases - epidemiology; Urologic Diseases - therapy; Japan; Human; spinal cord injury; Nervous system diseases; Urinary system disease; Vertebral canal; Physician; Malignant tumor; Urinary tract disease; Bladder cancer; Japanese; urologic surveillance; urologic complication; Clinical management; Surveillance; Spinal cord trauma; Central nervous system disease; Neurogenic bladder; Complication; Bladder disease; Neurological disorder; Spinal cord disease
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101854

Analysis of answers to a new questionnaire. To examine current practice patterns of physicians in the urological surveillance and management of spinal cord injury (SCI) patients in Japan. Nationwide questionnaire survey to physicians in Japan. A Japanese version of the 14-item questionnaire survey carried out in US was mailed to 770 members of the Japanese Neurogenic Bladder Society (JNBS). We received answers to our questionnaire from 333 (43.2%) members of JNBS. The responders were all urologists. For surveillance of the upper urinary tract (UUT), 239 (71.8%) respondents preferred abdominal ultrasound. Cystometry was performed routinely by 174 (52.3%) respondents for the evaluation of vesicourethral function. Cystoscopy was carried out in cases of hematuria (88.0%) and bladder stone (55.3%). Surveillance of the urinary tract was performed every year in 154 (46.2%). For detection of bladder cancer, which 119 (37.9%) respondents have experienced, 94.9% physicians perform cystoscopy, 76.3% urinary cytology, and 60.4% ultrasound. For initial treatment of detrusor-sphincter dyssynergia (DSD), 225 (69.2%) respondents chose alpha-blocker, and 94 (28.9%) chose clean intermittent catheterization (CIC) with/without anticholinergic agent(s). For initial treatment of overactive bladder, 245 (74.7%) chose anticholinergic agent(s) only and 63 (19.2%) chose anticholinergic agent(s) with CIC. For initial treatment of areflexic bladder, 233 (73.7%) chose CIC and 63 (19.9%) chose Credé maneuver or tapping. This survey shows that there are some differences in urological surveillance and management of SCI patients between Japan and the US. Reasons for the discrepancy should be examined.