European Urology Open Science (Dec 2024)
Incidence of and Risk Factors for Urinary Stones Among Patients with Spinal Cord Injury: A Systematic Review with Meta-analysis
Abstract
Background and objective: Urinary stones are a significant and common complication among patients with spinal cord injury (SCI), but epidemiological data are scarce and the evidence regarding risk factors remains unclear. Our aim was to investigate the incidence of and risk factors for urinary stones in SCI patients to provide evidence for better prevention and treatment strategies. Methods: Relevant studies were identified from the PubMed, Web of Science, Cochrane, Embase, and Scopus databases. Literature screening, information extraction, and quality evaluation were conducted in accordance with established standards. Data analysis was performed using the metaprop and metan commands in Stata 16.0. Key findings and limitations: A total of 65 studies involving 64 059 patients were included in the analysis. Meta-analysis using a random-effects model revealed that the overall incidence of urinary stones after SCI was 16.6% (95% confidence interval 14.1–19.3%). Over time, the incidence rate has stabilized between 15% and 20%, although annual rates varied significantly, ranging from 2.2% to 68.7%. The highest incidence was observed for bladder stones, with lower incidence rates for kidney and ureteral stones. Among the 13 factors assessed, male sex, a complete injury, and the use of intermittent, indwelling, and condom catheters were identified as independent risk factors for urinary stones. Conclusions and clinical implications: The incidence of urinary stones after SCI is high, with a number of risk factors identified. However, further high-quality research is needed to explore additional potential risk factors. Patient summary: We reviewed the results of previous studies on urinary stones in patients with a spinal cord injury. We found a high rate of urinary stones of about 17% for this patient group. Males are more prone to urinary stones and use of a catheter is a risk factor. More research is needed to identify other risk factors.
