Surveillance for common urologic complications after spinal cord injury (SCI) is not consistent, without consensus among clinical practice guidelines. The Paralyzed Veterans of America has issued a clinical practice guideline with recommendations including a yearly urologist visit, a serum creatinine, and a renal ultrasound. These recommendations are the least intensive urologic follow-up of the various other clinical practice guidelines for SCI. We present adherence to these screening guidelines at a non-designated SCI center as a bellwether for urologic care after SCI.

We identified all patients with documented SCI seen at the Ralph H. Johnson VA Medical Center between January 2014 and December 2015 and evaluated whether patients received an urologist visit, serum creatinine measurement and upper tract imaging during the study period.

99 patients were identified with SCI [Demographics in Table 1]. 49% of patients had a complete urologic surveillance. Those patients with a complete evaluation did not live closer to the care facility (p=0.40) or the designated SCI center in Augusta (p = 0.13).  There was no difference in age (p=0.18), race (p=0.64), SCI level (p=0.16) ASIA impairment (p=0.39), ambulatory status (p=0.27), comorbidities (p=0.83) or bladder management (p=0.14). Those with a complete evaluation were more likely to have had a urology visit (p<0.0001), to have had cystoscopy (p=0.001), cytology (p=0.03), and urodynamics (p<0.00001). There was no difference in hospitalization for urinary tract infections in those who had a complete evaluation and those who did not (18.4%, p=0.09).

Approximately half of veterans with a spinal cord injury at a non-designated SCI center Veterans Affairs Hospital receive the recommended urologic surveillance. There are no predictive factors for who is more likely to receive a complete evaluation.

Surveillance for common urologic complication after spinal cord injury per the Paralyzed Veterans of America clinical practice guideline including a yearly urologist visit, serum creatinine and upper tract imaging was performed in 49% of Veterans with SCI seen at a single non-designated SCI center Veterans Affairs Hospital. There were no identifiable predictive factors to aid in determining who is most likely to receive a complete evaluation.