Background/Objectives: Autonomic dysreflexia (AD) is a clinical syndrome affecting persons with spinal cord injury (SCI). The aim of the study was to present the experience of individuals with SCI and AD in Croatia. Single-center questionnaire study. Setting: Faculty of Medicine, University of Rijeka, Rijeka, Croatia. Persons with SCI were divided into those with an SCI at T6 and above (n = 41) and those with an SCI at T7 and below (n = 29). Based on anamnestic data, patients with an SCI at T6 and above were further divided into those with and without self-reported clinical symptoms of AD (respectively: n = 33 and n = 8). Methods: The online survey included 23 questions of various types. It consisted of a general (demographic) section, section with specific questions about AD, and a section on self-assessment and quality of life. Based on the answers, the experience and knowledge of AD among individuals with an SCI in Croatia was assessed. Results: A total of 70 individuals with an SCI completed the whole survey. The average age was 40.6 years. The patients were predominantly male (72.9%) and mostly with a traumatic SCI (84.3%). Of the 70 individuals with an SCI, 35 (50%) reported they were familiar with AD, with the majority indicating that the internet was their primary source of information. Among those with an SCI who were unaware of AD, most (34/35 = 97.1%) wanted to learn about AD. The self-assessed quality of life was insignificantly better in patients with an SCI below T6 than in those with higher lesions. Patients with AD reported different symptoms and the most frequently reported symptom was a headache (70%). In 64% of participants, the primary trigger of AD were issues with the urinary bladder. In most individuals (55%), symptoms were not recognized by the healthcare providers. The individuals with AD were dissatisfied with the information about AD they received from doctors or nurses. Overall, 61% of all participants with AD rated their quality of life as good. Conclusions: Persons with an SCI are not adequately informed about AD. In most persons with AD, their symptoms are not properly recognized by healthcare providers. Our results suggest the need for more education of healthcare professionals about AD.

Background: Stress urinary incontinence is one of the most common and debilitating complications following radical prostatectomy. Artificial urinary sphincter (AUS) implantation is the gold standard treatment for moderate to severe post-prostatectomy incontinence. Common complications include device infection, mechanical failure, component migration, urethral erosion, and urethral atrophy, which often require device removal and subsequent reimplantation. To our knowledge, erosion or migration of orthopedic osteosynthesis screws into the lower urinary tract causing new-onset urinary symptoms after AUS implantation has not previously been reported. Case Presentation: A 57-year-old man with an implanted AUS presented to the emergency department with fever, dysuria, and de novo urge incontinence. Intravenous antibiotic therapy was initiated, resulting in resolution of the fever, after which further diagnostic evaluation was performed. Cystoscopy demonstrated normal urethral coaptation and intact urethral mucosa at the cuff site. However, three orthopedic osteosynthesis screws from previous pelvic fracture fixation were identified protruding immediately below the bladder neck. The screws were removed by open surgery during ongoing empirical antimicrobial therapy. Four weeks later, the AUS was reactivated. At 8-month follow-up, the patient remained asymptomatic and maintained the same continence status as following AUS implantation. Conclusions: A detailed history of previous pelvic surgery and orthopedic fixation, together with review of available imaging, is important in candidates for AUS implantation. In patients presenting with new-onset urinary symptoms after AUS implantation, alternative etiologies should be considered, with cross-sectional imaging and cystoscopy used selectively according to the clinical presentation.