Urological Manifestations and Management Patterns of Clinically Established Neurogenic Bladder Following Thoracolumbar Spinal Cord Injury: A Hospital-Based Observational Study

Background: Neurogenic bladder is a frequent and significant complication of thoracolumbar spinal cord injury that can lead to urinary tract infection, upper urinary tract injury, and decreased quality of life. This study aimed to describe the urological manifestations and management pattern of patients with thoracolumbar spine injury who presented with neurogenic bladder at a tertiary care hospital. Methods: This observational study was carried out at Dhaka National Medical College and Hospital from July 2024 to June 2025 on 35 patients. A structured questionnaire was used to gather data on sociodemographic variables, injury characteristics, urinary symptoms, clinical and diagnostic profile, complications and management, which was analyzed using SPSS version 26. Results: Most participants were male (77.1%), rural residents (65.7%), and aged 31-40 years (31.4%). The most common injury mechanisms were falls from height (45.7%) and road traffic accidents (37.1%), with the thoracolumbar junction being the most frequently injured (42.9%). Urinary retention (71.4%) and difficulty initiating urination (62.9%) were the most common symptoms. The most common pattern was an areflexic bladder (51.4%), 42.9% had a post-void residual greater than 300 mL, and 17.1% had hydronephrosis. 51.4% of participants had a urinary tract infection. The most common bladder-emptying method was indwelling catheterization (40%), and only 34.3% had urodynamic evaluation, while 37.1% had regular follow-up. Conclusions: This study shows significant urological burden due to neurogenic bladder following thoracolumbar spine injury, and there are deficiencies in urodynamic monitoring, guideline-concordant catheterization and structured follow-up, suggesting the need for standardized, protocol-driven bladder-management pathways. J Dhaka National Med. Coll. Hos. 2026; 32 (02): 07-13