Bladder Managment for Adults with Spinal Cord Injury - 42

42

BLADDER MANAGEMENT FOR ADULTS WITH SPINAL CORD INJURY

(Scientific evidence–III; Grade of recommendation–C; Strength of panel opinion–Strong)

Rationale: Indwelling catheters may result in urethral damage that is difficult to correct surgically and may result in urinary incontinence. In contrast to diversion, cutaneous ileovesicostomy requires preservation of the bladder and possibly closure of the bladder outlet. The method does, however, preserve the ureterovesical juncture and perhaps provide protection of the upper urinary tract (Juma, Mostafavi, and Joseph, 1995; Stonehill et al., 1996). 2. Be prepared to perform secondary procedures that may be needed to prevent urethral incontinence (i.e., on the bladder neck in conjunction with augmentation or suprapubic cystostomy or cutaneous ileovesicostomy).
(Scientific evidence–III; Grade of recommendation–C; Strength of panel opinion–Strong)

Recommendations for Future Research
With regard to SCI bladder management, the initial and secondary-level literature searches, grading of the quality of research for identified literature citations, panel discussions, and field reviews revealed a number of areas that need further research. These include: Prospective studies on SCI nursing bladder management issues. Impact of various types of bladder management on the quality of life following SCI. Prospective studies on risks, complications, and benefits of current SCI bladder management methods. Prospective studies on comparing the risks, complications, and benefits of currently used SCI bladder management methods. Prospective evaluations on the impact of pharmacological treatment of bladder and sphincter function following SCI. Role of newer modalities, such as botulinum toxin, stem cell research, and tissue cloning on SCI bladder management. Effective ways to educate patients on bladder management following SCI.

Rationale: Individuals with an incontinent bladder outlet may continue to leak urine with either a suprapubic cystostomy or cutaneous ileovesicostomy. Bladder neck closure at the time of surgery will usually prevent this. The procedure must be done meticulously or fistulas can occur (Bennett et al., 1992; Juma, Mostafavi, and Joseph, 1995; Stonehill et al., 1996).



Bladder Managment for Adults with Spinal Cord Injury

Table of Contents for the Digital Edition of Bladder Managment for Adults with Spinal Cord Injury

Bladder Management for Adults with Spinal Cord Injury
Contents
Foreword
Preface
Acknowledgments
Panel Members
Contributors
Summary of Recommendations
The Consortium for Spinal Cord Medicine
Introduction
Recommendations
Recommendations for Future Research
Appendix A: Economic Considerations for Bladder Management Methods
References
Index
Bladder Managment for Adults with Spinal Cord Injury - Bladder Management for Adults with Spinal Cord Injury
Bladder Managment for Adults with Spinal Cord Injury - i
Bladder Managment for Adults with Spinal Cord Injury - ii
Bladder Managment for Adults with Spinal Cord Injury - Contents
Bladder Managment for Adults with Spinal Cord Injury - Foreword
Bladder Managment for Adults with Spinal Cord Injury - Preface
Bladder Managment for Adults with Spinal Cord Injury - Acknowledgments
Bladder Managment for Adults with Spinal Cord Injury - Panel Members
Bladder Managment for Adults with Spinal Cord Injury - Contributors
Bladder Managment for Adults with Spinal Cord Injury - ix
Bladder Managment for Adults with Spinal Cord Injury - Summary of Recommendations
Bladder Managment for Adults with Spinal Cord Injury - 2
Bladder Managment for Adults with Spinal Cord Injury - 3
Bladder Managment for Adults with Spinal Cord Injury - 4
Bladder Managment for Adults with Spinal Cord Injury - 5
Bladder Managment for Adults with Spinal Cord Injury - 6
Bladder Managment for Adults with Spinal Cord Injury - The Consortium for Spinal Cord Medicine
Bladder Managment for Adults with Spinal Cord Injury - 8
Bladder Managment for Adults with Spinal Cord Injury - 9
Bladder Managment for Adults with Spinal Cord Injury - 10
Bladder Managment for Adults with Spinal Cord Injury - 11
Bladder Managment for Adults with Spinal Cord Injury - 12
Bladder Managment for Adults with Spinal Cord Injury - Introduction
Bladder Managment for Adults with Spinal Cord Injury - 14
Bladder Managment for Adults with Spinal Cord Injury - 15
Bladder Managment for Adults with Spinal Cord Injury - 16
Bladder Managment for Adults with Spinal Cord Injury - Recommendations
Bladder Managment for Adults with Spinal Cord Injury - 18
Bladder Managment for Adults with Spinal Cord Injury - 19
Bladder Managment for Adults with Spinal Cord Injury - 20
Bladder Managment for Adults with Spinal Cord Injury - 21
Bladder Managment for Adults with Spinal Cord Injury - 22
Bladder Managment for Adults with Spinal Cord Injury - 23
Bladder Managment for Adults with Spinal Cord Injury - 24
Bladder Managment for Adults with Spinal Cord Injury - 25
Bladder Managment for Adults with Spinal Cord Injury - 26
Bladder Managment for Adults with Spinal Cord Injury - 27
Bladder Managment for Adults with Spinal Cord Injury - 28
Bladder Managment for Adults with Spinal Cord Injury - 29
Bladder Managment for Adults with Spinal Cord Injury - 30
Bladder Managment for Adults with Spinal Cord Injury - 31
Bladder Managment for Adults with Spinal Cord Injury - 32
Bladder Managment for Adults with Spinal Cord Injury - 33
Bladder Managment for Adults with Spinal Cord Injury - 34
Bladder Managment for Adults with Spinal Cord Injury - 35
Bladder Managment for Adults with Spinal Cord Injury - 36
Bladder Managment for Adults with Spinal Cord Injury - 37
Bladder Managment for Adults with Spinal Cord Injury - 38
Bladder Managment for Adults with Spinal Cord Injury - 39
Bladder Managment for Adults with Spinal Cord Injury - 40
Bladder Managment for Adults with Spinal Cord Injury - 41
Bladder Managment for Adults with Spinal Cord Injury - Recommendations for Future Research
Bladder Managment for Adults with Spinal Cord Injury - Appendix A: Economic Considerations for Bladder Management Methods
Bladder Managment for Adults with Spinal Cord Injury - 44
Bladder Managment for Adults with Spinal Cord Injury - References
Bladder Managment for Adults with Spinal Cord Injury - 46
Bladder Managment for Adults with Spinal Cord Injury - 47
Bladder Managment for Adults with Spinal Cord Injury - 48
Bladder Managment for Adults with Spinal Cord Injury - 49
Bladder Managment for Adults with Spinal Cord Injury - Index
Bladder Managment for Adults with Spinal Cord Injury - Cover4
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