Towards a catheter free status in neurogenic bladder dysfunction: a reviewof bladder management options in spinal cord injury (SCI)

Study design: Review. Objectives: To assess current available options for bladder management in S CI patients the post-acute phase. Methods: Relevant articles were extracted from medline and Cinahl between 1 966-1999. In addition, references earlier than 1966 that were listed in the se articles were identified and extracted. Results: Catheterisation (indwelling or self intermittent) is still carried out by the majority of SCI patients with more morbidity for indwelling cat heterisation. Other methods include condom drainage, suprapubic tapping and supreapubic pressure are used and are associated with less complications. Complicated procedures like sacral anterior root stimulator and entero-cyst oplasty are carried out with the onset of or impending complications. Conclusion: Several methods of bladder management are available in the post -acute phase of SCI. The method used has to be based on urodynamic characte ristics with the aim of producing a continent bladder with adequate low pre ssure storage capacity. Modern management of the bladder in SCI has success fully reduced renal related mortality in SCI from 95% in the first half of the 20th century to the present 3%.