Management of the Bladder in Spinal Cord Injury Patients

Management of the lower urinary tract in spinal cord injury patients can be very challenging The decision-making process should be based on the individual patient symptoms, which could vary even between patients with a similar level of injury, and an appropriate evaluation. Important factors in the evaluation of patients with neurogenic bladder secondary to spinal cord injury include intravesical detrusor storage pressures, integrity of the outlet, upper extremity function, and the ability to perform clean intermittent catheterization, as well as patient preference when choosing between the various conservative and surgical treatment options available. When used appropriately, treatment of neurogenic bladder can lead to significant improvements in urinary continence, protection of the upper urinary tracts, improved quality of life, and patient independence. This paper reviews the various options available today as well as several potential therapies that may become available in the future.