Urologic status of 74 spinal cord injury patients from the 1976 tangshan earthquake, and managed for over 20 years using the Crede maneuver

Abstract

Objective: To evaluate the urologic safety of long-term Crede maneuver as bladder management in spinal cord injured patients. Methods: Seventy-four paraplegics were included in this cross-sectional study. They were injured in the Tangshan earthquake in 1976. All patients have large volume (flaccid) bladders and have practiced the Crede maneuver for more than 20 years to expel urine. Current residual urine volume and urologic complications were investigated. Results: 93.2% of patients have residual urine larger than 100 ml and 50% of cases larger than 300 ml. The prevalence of urologic complications is high: pyuria in 82.4%, urinary lithiasis in 31.3%, ureteral dilatation in 59.5%, hydronephrosis in 35.1% and renal damage in 16.2%. Men are more susceptible to upper urinary tract deterioration than women (P<0.05). Conclusion: The Crede maneuver is not safe for long-term use in spinal cord injury patients, especially in men.