Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder: A multicenter survey

Sean P. Elliott, Rodrigo Villar, Burris R Duncan

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Purpose: We assessed how groups at spina bifida clinics evaluate and manage the urinary tract in patients with spina bifida, neurogenic bladder and bacteriuria. Materials and Methods: A survey was mailed to all 169 clinics listed by the Spina Bifida Association of America. Survey items addressed baseline and surveillance evaluation, criteria used to assess urinary tract health and approaches to treatment in patients with spina bifida and neurogenic bladder. Results: Of the 169 clinics personnel at 59 (35%) responded to the survey. Almost half of the respondents had an established protocol or standard of care. At most clinics the use of ultrasound (93%), voiding cystourethrograms (85%) and urodynamic testing (76%) was supported but not renal isotopic studies (14%) or excretory urograms (2%) for baseline evaluation. At all clinics ultrasound was supported for routine surveillance but there was no consensus for other imaging modalities. Assessment of clinic approaches to the evaluation and management of bacteriuria demonstrated variable results, although at most clinics fever, flank pain, dysuria, and changes in urinary pattern were identified as being consistent with true infection. Groups at clinics following their protocol or standard of care showed no significant differences in their approach compared to those at clinics lacking a protocol or standard of care. Conclusions: No consensus exists for the evaluation and management of bacteriuria in patients with spina bifida and neurogenic bladder at clinics specializing in the care of such patients, even at those with established standards of care. A clear need exists for an established, national set of evidence based guidelines to assist medical decision making in this high risk population and, thus, improve care.

Original languageEnglish (US)
Pages (from-to)217-220
Number of pages4
JournalJournal of Urology
Volume173
Issue number1
DOIs
StatePublished - Jan 2005

Fingerprint

Neurogenic Urinary Bladder
Bacteriuria
Spinal Dysraphism
Standard of Care
Urinary Tract
Flank Pain
Dysuria
Urography
Urodynamics
Patient Care
Fever
Surveys and Questionnaires
Guidelines
Kidney
Health
Infection
Population

Keywords

  • Bacteriuria
  • Bladder
  • Bladder, neurogenic
  • Spinal dysraphism
  • Urinary tract

ASJC Scopus subject areas

  • Urology

Cite this

Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder : A multicenter survey. / Elliott, Sean P.; Villar, Rodrigo; Duncan, Burris R.

In: Journal of Urology, Vol. 173, No. 1, 01.2005, p. 217-220.

Research output: Contribution to journalArticle

@article{a222670516844434b356830118a64631,
title = "Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder: A multicenter survey",
abstract = "Purpose: We assessed how groups at spina bifida clinics evaluate and manage the urinary tract in patients with spina bifida, neurogenic bladder and bacteriuria. Materials and Methods: A survey was mailed to all 169 clinics listed by the Spina Bifida Association of America. Survey items addressed baseline and surveillance evaluation, criteria used to assess urinary tract health and approaches to treatment in patients with spina bifida and neurogenic bladder. Results: Of the 169 clinics personnel at 59 (35{\%}) responded to the survey. Almost half of the respondents had an established protocol or standard of care. At most clinics the use of ultrasound (93{\%}), voiding cystourethrograms (85{\%}) and urodynamic testing (76{\%}) was supported but not renal isotopic studies (14{\%}) or excretory urograms (2{\%}) for baseline evaluation. At all clinics ultrasound was supported for routine surveillance but there was no consensus for other imaging modalities. Assessment of clinic approaches to the evaluation and management of bacteriuria demonstrated variable results, although at most clinics fever, flank pain, dysuria, and changes in urinary pattern were identified as being consistent with true infection. Groups at clinics following their protocol or standard of care showed no significant differences in their approach compared to those at clinics lacking a protocol or standard of care. Conclusions: No consensus exists for the evaluation and management of bacteriuria in patients with spina bifida and neurogenic bladder at clinics specializing in the care of such patients, even at those with established standards of care. A clear need exists for an established, national set of evidence based guidelines to assist medical decision making in this high risk population and, thus, improve care.",
keywords = "Bacteriuria, Bladder, Bladder, neurogenic, Spinal dysraphism, Urinary tract",
author = "Elliott, {Sean P.} and Rodrigo Villar and Duncan, {Burris R}",
year = "2005",
month = "1",
doi = "10.1097/01.ju.0000146551.87110.f4",
language = "English (US)",
volume = "173",
pages = "217--220",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Bacteriuria management and urological evaluation of patients with spina bifida and neurogenic bladder

T2 - A multicenter survey

AU - Elliott, Sean P.

AU - Villar, Rodrigo

AU - Duncan, Burris R

PY - 2005/1

Y1 - 2005/1

N2 - Purpose: We assessed how groups at spina bifida clinics evaluate and manage the urinary tract in patients with spina bifida, neurogenic bladder and bacteriuria. Materials and Methods: A survey was mailed to all 169 clinics listed by the Spina Bifida Association of America. Survey items addressed baseline and surveillance evaluation, criteria used to assess urinary tract health and approaches to treatment in patients with spina bifida and neurogenic bladder. Results: Of the 169 clinics personnel at 59 (35%) responded to the survey. Almost half of the respondents had an established protocol or standard of care. At most clinics the use of ultrasound (93%), voiding cystourethrograms (85%) and urodynamic testing (76%) was supported but not renal isotopic studies (14%) or excretory urograms (2%) for baseline evaluation. At all clinics ultrasound was supported for routine surveillance but there was no consensus for other imaging modalities. Assessment of clinic approaches to the evaluation and management of bacteriuria demonstrated variable results, although at most clinics fever, flank pain, dysuria, and changes in urinary pattern were identified as being consistent with true infection. Groups at clinics following their protocol or standard of care showed no significant differences in their approach compared to those at clinics lacking a protocol or standard of care. Conclusions: No consensus exists for the evaluation and management of bacteriuria in patients with spina bifida and neurogenic bladder at clinics specializing in the care of such patients, even at those with established standards of care. A clear need exists for an established, national set of evidence based guidelines to assist medical decision making in this high risk population and, thus, improve care.

AB - Purpose: We assessed how groups at spina bifida clinics evaluate and manage the urinary tract in patients with spina bifida, neurogenic bladder and bacteriuria. Materials and Methods: A survey was mailed to all 169 clinics listed by the Spina Bifida Association of America. Survey items addressed baseline and surveillance evaluation, criteria used to assess urinary tract health and approaches to treatment in patients with spina bifida and neurogenic bladder. Results: Of the 169 clinics personnel at 59 (35%) responded to the survey. Almost half of the respondents had an established protocol or standard of care. At most clinics the use of ultrasound (93%), voiding cystourethrograms (85%) and urodynamic testing (76%) was supported but not renal isotopic studies (14%) or excretory urograms (2%) for baseline evaluation. At all clinics ultrasound was supported for routine surveillance but there was no consensus for other imaging modalities. Assessment of clinic approaches to the evaluation and management of bacteriuria demonstrated variable results, although at most clinics fever, flank pain, dysuria, and changes in urinary pattern were identified as being consistent with true infection. Groups at clinics following their protocol or standard of care showed no significant differences in their approach compared to those at clinics lacking a protocol or standard of care. Conclusions: No consensus exists for the evaluation and management of bacteriuria in patients with spina bifida and neurogenic bladder at clinics specializing in the care of such patients, even at those with established standards of care. A clear need exists for an established, national set of evidence based guidelines to assist medical decision making in this high risk population and, thus, improve care.

KW - Bacteriuria

KW - Bladder

KW - Bladder, neurogenic

KW - Spinal dysraphism

KW - Urinary tract

UR - http://www.scopus.com/inward/record.url?scp=10344221611&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10344221611&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000146551.87110.f4

DO - 10.1097/01.ju.0000146551.87110.f4

M3 - Article

C2 - 15592079

AN - SCOPUS:10344221611

VL - 173

SP - 217

EP - 220

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -