Contemporary diagnostic methods of the urinary system in patients after spinal injury with subsequent neurological deficits: Diagnostics of the lower urinary tract

Introduction: Spinal injury with neurological deficit usually results in a neurogenic bladder disorder. The problem may range from total lack of micturition during the spinal shock phase to various forms of detrusor-sphincter dyssynergia. Typical consequences include increased intra-vesical pressure, inability to effectively empty the bladder, increased risk of vesico-ureteral reflux, infection, bladder or kidney stones, neoplastic complications within the urinary tract and renal failure. Proper diagnostics of urinary tract function and morphology enables choosing adequate bladder emptying strategy, early diagnosis and effective treatment of urinary complications in patients after spinal injury with neurological deficit.Study purpose: Presentation of contemporary methods of functional, imaging and endoscopic diagnostic tests of the lower urinary tract in patients with spinal injury with neurological deficit. We discuss clinical value and accuracy of particular diagnostic methods in prevention and monitoring of the therapy of urinary complications.Study form: Literature review.Conclusions: Although urodynamic studies serve as the principal tool among the modern methods of the lower urinary tract function assessment, simple functional tests such as measurement of residual urine volume measurement or cystometrogram may be helpful in clinical practice, particularly during the early post-traumatic phase. Ultrasonographic examination is the first choice imaging study. Clinical validity of screening cystoscopy in spinal injury with neurological deficit patients remains doubtful, but this procedure is of unquestionable value in cases with haematuria.