Spinal cord injury can cause a variety of long-term complications. One of the most significant and life-threatening being deterioration of renal function. Treatment and intensity of follow-up examination are based on the type of neuro-urological disorder and underlying cause.
The aim of this review is to evaluate the surveillance protocol for imaging the urinary tract for patients with various spinal cord pathologies in a national spinal cord injury unit.

Retrospective data collection over ten years’ period for patients from a single national spinal injury unit. Radiological images and patient’s clinical notes, including symptoms and renal function, were reviewed via Picture Archiving and Communication System (PACS)  and Electronic Document and Management System (EDMS) , respectively.

Over the ten years’ period, random selection of forty patients were selected. Thirty-five patients (87%) were followed up for ten years. Five patients (13%) deceased during follow up. Twenty patients (50%) had Infrapontine and Suprasacral pathology. Fifteen patients had Sacral/Infrasacral pathology, including eight spina-bifida.
Bladder management among this cohort varied, 40% performing Intermittent Self-Catheterisation, Reflex Voiding, Artificial Urinary Sphincter (AUS), suprapubic catheter or long term indwelling catheter, incontinence pads and condom sheath catheter. 
During the ten-years follow up period, twenty eight patients (80%) had at least five surveillance Ultrasound scan of Kidney-Ureter-Bladder (USS-KUB), the remaining had <5 surveillance scan.  
Initial USS-KUB in February 2009, identified three (8%) pre-existing existing pathologies. Subsequently six patients (17%) developed new pathology on USS-KUB over ten years follow up, this prompted adjustment of their bladder management. Five patients (14%) were found to have incidental findings that did not impact their management.

This sample covered a wide range of spinal cord pathologies. This revealed various methods of bladder management that was guided by the nature of the neuro-pathology. The majority of patients had at least one radiological follow up to monitor their urinary tract. Significant proportion of this cohort developed biochemical or radiological complications that prompted altering their method of bladder management to optimise their renal function and minimise long-term consequences related to renal function deterioration.

This review concluded that adequate surveillance protocol for USS-KUB was implemented in our cohort, over the ten years’ period. This highlighted the importance of personalised frequency of surveillance of ultrasound scans, in addition to adjustment of bladder management methods, is dictated by the nature of patient’s spinal cord pathology identified to maintain renal function and minimise the longterm complications of renal function deterioration on this cohort of patients.