Bladder Managment for Adults with Spinal Cord Injury - iv

BLADDER MANAGEMENT FOR ADULTS WITH SPINAL CORD INJURY

Foreword

eurogenic bladder occurs in most individuals who have a spinal cord injury (SCI). During World War I, 39 percent of those with spinal cord injury died from acute urinary tract infections (UTIs). During World War II, this number dropped to 10 percent, but the most common cause of death from spinal cord injury became renal failure. Currently, although UTIs occur frequently in those with SCI, death from this cause is extremely unusual. And less than 3 percent of deaths following SCI are now attributable to chronic renal failure. This dramatic decline in morbidity and mortality from urological causes has been a result of the advent of antibiotics, effective bladder management, and frequent monitoring of the upper and lower urinary tracts. This guideline was developed to describe the various methods of bladder management in adults with SCI. The panel decided to address this guideline not only to caregivers who are familiar with SCI, but also to those who infrequently manage individuals with SCI. The panel also decided not to recommend one single method of management, but rather to discuss the indications, advantages and disadvantages, nursing issues, and economic considerations of each of the most popular methods. There are a couple of reasons for this. The first is that there is no strong scientific evidence that one method is superior to another. The second is that health-care providers who are familiar with the various methods can offer the best help and advice to the individuals in their care. It is important that individuals with SCI understand the pros and cons of the various methods of bladder management in a fair and unbiased way. Patient education should include a balanced discussion of the effect each method will have on health, lifestyle, and sexuality, as the comparative cost of each method and the availability of expert follow-up. The decision of which method to choose can then be made after all of the various factors have been weighed. In developing this guideline, panel members looked carefully at the scientific literature and at expert opinion. The goal was to provide both individuals with SCI and the health-care providers who advise them with the best and most up-todate information on the wide variety of bladder management techniques available to them. The guideline recommendations consider who is—and who is not—a good candidate for each method as well as the associated contraindications. In doing so the panel sought to list the most common attributes of each method, based on the literature, rather than try to discuss every possible reason why a particular method should or should not be used. I hope this guideline will help you in your practice as you care for and educate SCI individuals with neurogenic bladders. I also hope that the guideline will stimulate further clinical studies in this important area. Todd A. Linsenmeyer, MD Chairman

Bladder Managment for Adults with Spinal Cord Injury

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