Bladder tissue biopsies in spinal cord injured patients: histopathologic aspects of 61 cases

Abstract

It was the aim of this histopathologic study to examine and compare results of bladder tissue biopsies in spinal cord injured (SCI) patients. The study group consisted of 61 SCI patients who received treatment at the Swiss Paraplegic Centre in Nottwil, near Lucerne, Switzerland. The mean age of the study group was 41 years (range, 17-73) and the mean duration of spinal cord lesion was 10 years and 4 months (range, 5 months to 44 years). The male:female ratio was 57:4. Bladder infections had occurred in each patient one to six times per year (median, 3.2). All samples were taken from the trigone of the bladder during endoscopic urologic procedures with a flexible cystoscope. Histopathologic analysis showed abnormal alterations of bladder tissue in 56 SCI patients (91.8%). Forty-six SCI patients (75.4%) had a chronic type and 10 SCI patients (16.4%) a subacute type of inflammation. Normal bladder tissue was found in five cases (8.2%). Further observation revealed the presence of fibrosis (34.4%), edema (9.8%), and lymphoid hyperplasia (6.6%). A t-test for independent samples showed a lack of significant correlation between the number of clinical bladder infections per year, the duration of injury, the neurologic level of the spinal cord lesion, and histopathologic types of infections.