Bladder Managment for Adults with Spinal Cord Injury - v

CLINICAL PRACTICE GUIDELINE

Preface

rological complications, including urinary tract infections and renal failure, were at one time the number one killer of persons with spinal cord injury. Thanks primarily to dramatic improvements in the management of the neurogenic bladder over the past 40 years, the lifespan of people with SCI now approaches that of the general population. Although UTIs continue to be a frequent complication for many with SCI, renal failure is rare. No other organ system has been studied as extensively in SCI as the urological system. And no other organ system has sparked such heated debate among specialists in terms of management in SCI. The Consortium for Spinal Cord Medicine brought together a team of experts in SCI urologic management to weigh the scientific evidence available and produce a document that identifies the very best practices for modern bladder management in individuals with SCI. Here in one document are the various options for bladder management, laid out in clear and concise language, and accompanied by the scientific arguments for the use of each option. Individuals today have lots of options available for safe management of the bladder following SCI. However, as with many decisions in medicine, there is rarely one perfect solution that will meet each person’s needs. A comprehensive assessment of the options available is necessary to find the management approach that will best fit his or her unique anatomy, neurophysiology, functional abilities, medical comorbidities, and social life. The decision often requires choosing the best option from among several imperfect solutions. To make the process successful requires the expertise of many persons, the most important of whom is the individual with SCI. Because compliance with any bladder management approach is the key to its success, it is essential for the individual with SCI to be both knowledgeable about and comfortable with daily implementation of the program. This document is the ninth clinical practice guideline published by the Consortium for Spinal Cord Medicine under the auspices of the Paralyzed Veterans of America. It offers exceptional insight into the appropriate management techniques of the neurogenic bladder based on science and clinical expertise. It does not prescribe one bladder management technique over another, but rather provides a compendium of management options, many of which may be appropriate for any one individual. In creating this document, each distinguished guideline development panel member brought to the table her or his energy, dedication, and passion for the care of people with SCI. The panel worked as a magnificent team under the leadership of panel chair Todd Linsenmeyer, MD, who deserves special thanks from the consortium steering committee for his enduring commitment and leadership. Special thanks also go to representatives of the consortium’s 21 member organizations, who thoughtfully and critically reviewed the draft in its various forms. Their input was essential to making this document one that will improve both the quality of care and the quality of life for persons with SCI. Michael Priebe, MD Chair, Steering Committee

Bladder Managment for Adults with Spinal Cord Injury

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