To review the available data on non-surgical management for neurogenic bladder in patients with spinal cord injury (SCI). Before the introduction of urinary catheters and antibiotics, neurogenic bladder was one of the main culprits for death in those patients with SCI. Currently, the management of neurogenic bladder is focused in improving quality of life and preserving renal function.
A literature review was performed and therapeutic management for neurogenic bladder was divided in six sections: (1) intermittent bladder catheterization; (2) indwelling catheters; (3) condom catheter drainage; (4) reflex voiding and bladder expression with Valsalva or Credé; (5) oral drug therapy of the spinal cord injured bladder; and (6) botulinum neurotoxin (BoNT).
Intermittent catheterization is recommended as the preferable method for management of neurogenic bladder in patients with SCI based on limited high-quality data. However, this may not be feasible or available to all and other alternative options include condom catheter drainage or indwelling catheters such as urethral catheters or suprapubic tube, reflex voiding, and bladder expression with Valsalva or Credé. Non-invasive medical therapies are the key to improve incontinence, urodynamic parameters, and quality of life in this population. Botulinum neurotoxin has revolutionized the management of neurogenic bladder in the last two decades decreasing the need for reconstruction or diversion.
The Joint SIU-ICUD (Société Internationale d'Urologie) (International Consultation on Urological Diseases) International Consultation reviewed the available presented data and provided specific conclusions and recommendations for each non-surgical urologic method to address neurogenic bladder after SCI.
World journal of urology. 2018 Jul 26 [Epub ahead of print]
Paholo G Barboglio Romo, Christopher P Smith, Ashley Cox, Márcio A Averbeck, Caroline Dowling, Cleveland Beckford, Paul Manohar, Sergio Duran, Anne P Cameron
University of Michigan, Ann Arbor, MI, USA., Baylor College of Medicine, Houston, TX, USA., Dalhousie University, Halifax, NS, Canada., Moinhos de Vento Hospital, Porto Alegre, Brazil., Royal Melbourne Hospital, Victoria, Australia., Centro Médico Nacional, Panama, Panama., Monash Health, Victoria, Australia., National Institute of Rehabilitation, Mexico City, Mexico., University of Michigan, Ann Arbor, MI, USA. .