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World Journal of Urology
Published in: World Journal of Urology 10/2018

01-10-2018 | Topic Paper

Non-surgical urologic management of neurogenic bladder after spinal cord injury

Authors: Paholo G. Barboglio Romo, Christopher P. Smith, Ashley Cox, Márcio A. Averbeck, Caroline Dowling, Cleveland Beckford, Paul Manohar, Sergio Duran, Anne P. Cameron

Published in: World Journal of Urology | Issue 10/2018

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Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusion

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.
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Metadata
Title
Non-surgical urologic management of neurogenic bladder after spinal cord injury
Authors
Paholo G. Barboglio Romo
Christopher P. Smith
Ashley Cox
Márcio A. Averbeck
Caroline Dowling
Cleveland Beckford
Paul Manohar
Sergio Duran
Anne P. Cameron
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 10/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2419-z

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