Bladder Management Strategies for Urological Complications in Patients with Chronic Spinal Cord Injury

J. Clin. Med., 2022 · DOI: 10.3390/jcm11226850 · Published: November 20, 2022

Simple Explanation

This review discusses how to manage bladder problems caused by spinal cord injuries to avoid complications. Proper bladder management is key to protecting the upper urinary tract, maintaining continence, and improving life quality. Clean intermittent catheterization (CIC) is recommended for bladder drainage due to lower risks of infection and stones compared to indwelling catheters. However, some patients opt for other methods based on comfort and convenience. Urological complications remain a major health issue for SCI patients, despite improved treatment options. The review evaluates different bladder management strategies and their effects on urinary tract infections (UTIs), incontinence, and renal function.

Study Duration

Not specified

Participants

SCI patients

Evidence Level

Review

Key Findings

1
Urinary tract infections (UTIs) are common post-SCI, with risk factors including cervical SCI, male sex, and catheterization. CIC is generally preferred over indwelling catheters to reduce UTI risk.
2
Poor bladder compliance is associated with chronic indwelling catheters. CIC or spontaneous voiding helps sustain normal bladder compliance.
3
Urolithiasis risk is higher in SCI patients, especially with indwelling catheters. Prevention involves UTI management, adequate fluid intake, and avoiding indwelling catheters if possible.

Research Summary

This review addresses the challenges of managing neurogenic lower urinary tract dysfunction (NLUTD) in chronic spinal cord injury (SCI) patients. It highlights the importance of proper bladder management strategies to minimize urological complications and improve patient outcomes. The paper discusses various bladder management options, including clean intermittent catheterization (CIC), indwelling catheters, and surgical interventions. It emphasizes that CIC is generally the preferred method due to lower rates of UTI and other complications. The review concludes that bladder management should be individualized, focusing on renal function preservation, UTI reduction, efficient bladder emptying, and patient agreement. Increased awareness of urological complications is necessary for SCI patients.

Practical Implications

Clinical Practice

Clinicians should prioritize CIC over indwelling catheters when possible for bladder management in SCI patients.

Patient Education

Healthcare providers need to educate SCI patients on the risks of NLUTD and the benefits of different bladder management strategies.

Future Research

Further studies are needed to evaluate the effectiveness of novel treatments like Beta-3-adrenergic receptor agonists and bladder instillations for managing NLUTD.

Study Limitations

1
The review relies on available data, which may have limitations in study design and patient populations.
2
Long-term outcomes and patient satisfaction with various bladder management strategies require further investigation.
3
The optimal management approach should be individualized, considering patient-specific factors and preferences.

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