BLADDER FUNCTION AND URINARY TRACT INFECTIONS IN SPINAL CORD INJURED DOGS

摘要

Micturition is a complex neurologic process that combines somatic and autonomic reflexes to achieve sphincter relaxation in coordination with bladder contraction. The neuroanatomical involvement of the nervous system is widespread including cortical decision-making, the pontine micturition center and cerebellar input, white matter tracts of the spinal cord, and autonomic and somatic peripheral nerves1. Of these structures, disruption of spinal cord white matter is the most common cause of failure ofnormal urination, and urine retention and overflow incontinence are frequent in our spinal cord injured patients. The consequences of this for our patients are well recognized, the most common being a predisposition to urinary tract infections (UTIs), but also including detrusor atony, urine scald, secondary hydroureter, hydronephrosis and pyelonephritis. In chronic paraplegics, recurrent, antibiotic resistant UTIs are a major concern and they a leading cause of morbidity and shortened lifespan in humans2"4. This presentation will discuss the current understanding of bladder function following spinal cord injury in our patients, and describe potential strategies to effectively treat and reduce the incidence of UTIs.